Healthcare Provider Details

I. General information

NPI: 1558593202
Provider Name (Legal Business Name): JAYNA ELISE ADAMS AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAYNA ELISE RASMUSSEN AU.D.

II. Dates (important events)

Enumeration Date: 08/13/2009
Last Update Date: 03/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 S AUSTIN AVE #370
GEORGETOWN TX
78626-7545
US

IV. Provider business mailing address

3201 S AUSTIN AVE #370
GEORGETOWN TX
78626-7545
US

V. Phone/Fax

Practice location:
  • Phone: 512-869-0604
  • Fax: 512-868-5936
Mailing address:
  • Phone: 512-869-0604
  • Fax: 512-868-5936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number80261
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: