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General NPI Number Information
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NPI Number | 1306257738
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Entity Type | Individual
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Provider Name | ALLEN NICHOLAS JARZOMBEK MD
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Gender | Male
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Dates
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Enumeration Date | 05/20/2014
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 3101 HIGHWAY 71 E STE 101
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City | BASTROP
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State | TX
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Zip | 78602-5159
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Country | US
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Telephone | 512-304-0300
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Fax | 855-270-9668
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Provider Business Mailing Address
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Address Line | 5625 EIGER RD STE 200
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City | AUSTIN
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State | TX
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Zip | 78735-8982
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Country | US
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Telephone | 512-892-7076
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Fax | 855-270-9668
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | S3000
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35152
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License Number State | AL
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