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General NPI Number Information
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NPI Number | 1417691700
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Entity Type | Individual
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Provider Name | JARED JACK BIES DO
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Gender | Male
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Dates
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Enumeration Date | 04/23/2022
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 11930 W US HIGHWAY 90
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City | SAN ANTONIO
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State | TX
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Zip | 78245-9576
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Country | US
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Telephone | 210-233-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 11930 W US HIGHWAY 90 STE 110
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City | SAN ANTONIO
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State | TX
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Zip | 78245-9613
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Country | US
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Telephone | 210-233-7000
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | V6872
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License Number State | TX
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