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General NPI Number Information
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NPI Number | 1528300555
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Entity Type | Individual
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Provider Name | JASON ROBERT ROSS M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2013
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 101 RAINBOW DR # 5250
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City | LIVINGSTON
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State | TX
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Zip | 77399-9301
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Country | US
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Telephone | 936-433-8303
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Fax |
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Provider Business Mailing Address
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Address Line | 101 RAINBOW DR # 5250
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City | LIVINGSTON
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State | TX
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Zip | 77399-9301
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Country | US
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Telephone | 936-433-8303
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | S0373
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | MD2022-0132
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35C.003137
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | S0373
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD2022-0132
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License Number State | NM
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD224324
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License Number State | OR
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