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General NPI Number Information
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NPI Number | 1063493039
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Entity Type | Individual
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Provider Name | JAYSON DAVID AYDELOTTE M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 1601 TRINITY ST STE 704F
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City | AUSTIN
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State | TX
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Zip | 78712-1765
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Country | US
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Telephone | 512-324-7873
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Fax | 512-380-7503
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Provider Business Mailing Address
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Address Line | 1500 RED RIVER ST
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City | AUSTIN
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State | TX
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Zip | 78701-1918
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Country | US
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Telephone | 512-324-7000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | N8483
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD036265
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | MD036265
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License Number State | DC
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Taxonomy #4
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | MD036265
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License Number State | DC
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