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NPI Code Detail

MEDICARE: JASON METCALFE RPSGT

MEDICARE: JASON METCALFE RPSGT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174H00000XHealth Educator
2246Z00000XOther Specialist/Technologist19983
3225500000XRespiratory/Developmental/Rehabilitative Specialist/Technologist19983

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
119983OTHERBOARD OF POLYSOMNOGRAPHIC TECHNOLOGISTS

General Provider Information

NPI Number : 1669086328
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON METCALFE RPSGT
Provider Business Mailing Address
First Line : 701 TILLERY ST STE 12
Second Line :
City : AUSTIN
State : TX
Zip : 78702-3751
Country : US
Telephone Number : 510-996-2688
Fax Number :
Provider Business Practice Location Address
First Line : 701 TILLERY ST STE 12
Second Line :
City : AUSTIN
State : TX
Zip : 78702-3751
Country : US
Telephone Number : 510-996-2688
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2020
Last Update Date : 09/01/2020

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Directions to “ JASON METCALFE RPSGT” Practice Location

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