Provider Demographics
NPI:1427788900
Name:JONES, MARY R
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:R
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 PACIFIC AVE STE 2000
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-4540
Mailing Address - Country:US
Mailing Address - Phone:855-446-2795
Mailing Address - Fax:
Practice Address - Street 1:1910 PACIFIC AVE STE 2000
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-4540
Practice Address - Country:US
Practice Address - Phone:855-446-2795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist