Provider Demographics
NPI:1366047540
Name:JOBE, SYDNEY NALLEY (DPT)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:NALLEY
Last Name:JOBE
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 1:2518 CARLOW DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-4328
Mailing Address - Country:US
Mailing Address - Phone:318-243-7607
Mailing Address - Fax:
Practice Address - Street 1:2518 CARLOW DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-4328
Practice Address - Country:US
Practice Address - Phone:512-215-9272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1339878OtherPHYSICAL THERAPY LICENSE
TX1339878OtherPHYSICAL THERPY LICENSE