Healthcare Provider Details

I. General information

NPI: 1043338338
Provider Name (Legal Business Name): JARED TATE READING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 02/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 GARNER FIELD RD
UVALDE TX
78801-4809
US

IV. Provider business mailing address

7703 FLOYD CURL DR MC7977
SAN ANTONIO TX
78229-3901
US

V. Phone/Fax

Practice location:
  • Phone: 830-278-6521
  • Fax: 830-278-8529
Mailing address:
  • Phone: 210-257-1400
  • Fax: 210-257-1428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberM5898
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: