Healthcare Provider Details

I. General information

NPI: 1780679886
Provider Name (Legal Business Name): JAY D. POND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ORTHOPEDIC WAY
ARLINGTON TX
76015-1629
US

IV. Provider business mailing address

PO BOX 120489
ARLINGTON TX
76012-0489
US

V. Phone/Fax

Practice location:
  • Phone: 817-375-5200
  • Fax: 817-299-1708
Mailing address:
  • Phone: 817-375-5200
  • Fax: 817-299-1708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberH9557
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: