Provider Demographics
NPI:1992284210
Name:JENNINGS, JULIA CAROL (DPT)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:CAROL
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8416 SEAWALL BLVD APT 5
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77554-7773
Mailing Address - Country:US
Mailing Address - Phone:713-703-6124
Mailing Address - Fax:
Practice Address - Street 1:9432 KATY FWY STE 320
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6370
Practice Address - Country:US
Practice Address - Phone:281-558-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1307979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist