Healthcare Provider Details

I. General information

NPI: 1851736243
Provider Name (Legal Business Name): JASON MARTIN MEDICAL CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 BELLA COLINAS DR
AUSTIN TX
78738-7631
US

IV. Provider business mailing address

208 BELLA COLINAS DR
AUSTIN TX
78738-7631
US

V. Phone/Fax

Practice location:
  • Phone: 832-797-7777
  • Fax: 512-535-0322
Mailing address:
  • Phone: 512-840-1158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JASON MARTIN
Title or Position: PRESIDENT
Credential: MD
Phone: 832-797-7777