Individual
TONSEL JACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1301 E BARDIN RD UNIT 181801, ARLINGTON, TX 76096-4272
(866) 488-4546
(178) 210-6624
Mailing address
1301 E BARDIN RD UNIT 181801, ARLINGTON, TX 76096-4272
(866) 488-4546
(178) 210-6624
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
871002728
PEDORTHIST
TX
Enumeration date
10/15/2021
Last updated
08/04/2025
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