Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeremy Michael Lake, PT

Individual provider Physical Therapist · NPI 1043849813

Jeremy Michael Lake, PT is a Physical Therapist in Fort Worth, Texas. Licensed in Texas. Registered with an NPI since 2020.

Licensed in
TX
In the registry since
2020
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

6601 Harris Pkwy
Fort Worth, TX 76132-6108
Phone: (817) 738-9866
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1143444 (TX)

Record details

NPI number1043849813
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedApril 3, 2020
Last updated in NPPESApril 3, 2020
Certification dateApril 3, 2020
Mailing address1713 Griffin Ln, Mansfield, TX 76063-8563

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