Billodeaux, Jennifer

Billodeaux, Jennifer is an individual health care provider with primary practice located at 110 Ruthlynn Dr. , Longview TX 75605-5634. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Billodeaux, Jennifer can be contacted via phone (903) 757-7731.

Contact Information

Primary practice address
110 Ruthlynn Dr. Longview TX 75605-5634
Phone: (903) 757-7731
Fax: (903) 757-3756
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 1142768 Texas

Profile Details

NPI number 1104044197
LBN Legal business name Billodeaux, Jennifer
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104044197 NPPES
Texas MEDICAID 021675601

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