Provider Demographics
NPI:1588736052
Name:HUNT, JASON WARD (PT, OCS)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:WARD
Last Name:HUNT
Suffix:
Gender:M
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 CHINQUAPIN CT
Mailing Address - Street 2:
Mailing Address - City:HALLSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75650-6224
Mailing Address - Country:US
Mailing Address - Phone:039-806-8461
Mailing Address - Fax:
Practice Address - Street 1:5848 JUDSON RD STE 201
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-1073
Practice Address - Country:US
Practice Address - Phone:903-806-8461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11418362251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic