Healthcare Provider Details

I. General information

NPI: 1629046370
Provider Name (Legal Business Name): JASON H RAMSDELL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 HESTERS CROSSING RD STE 101
ROUND ROCK TX
78681-8027
US

IV. Provider business mailing address

970 HESTERS CROSSING RD STE 101
ROUND ROCK TX
78681-8027
US

V. Phone/Fax

Practice location:
  • Phone: 512-238-0762
  • Fax: 512-341-7370
Mailing address:
  • Phone: 512-238-0762
  • Fax: 512-341-7370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0110001541
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA10523
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: