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General NPI Number Information
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NPI Number | 1174854210
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Entity Type | Individual
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Provider Name | JASON ANDREW NEWTON PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/28/2010
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 1500 S MAIN ST
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City | FORT WORTH
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State | TX
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Zip | 76104-4917
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Country | US
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Telephone | 817-702-3431
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Fax | 972-506-8733
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Provider Business Mailing Address
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Address Line | 200 W MAGNOLIA AVE STE 201
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City | FORT WORTH
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State | TX
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Zip | 76104-7657
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Country | US
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Telephone | 817-702-2977
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Fax | 972-702-2140
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA06581
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License Number State | TX
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