Provider Demographics
NPI:1912165937
Name:BOBB, JEFFREY A (OTC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:BOBB
Suffix:
Gender:M
Credentials:OTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4351 BOOTH CALLOWAY RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7378
Mailing Address - Country:US
Mailing Address - Phone:817-589-0768
Mailing Address - Fax:817-284-3700
Practice Address - Street 1:4351 BOOTH CALLOWAY RD
Practice Address - Street 2:SUITE 203
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-7378
Practice Address - Country:US
Practice Address - Phone:817-589-0768
Practice Address - Fax:817-284-3700
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist