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General NPI Number Information
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NPI Number | 1598152217
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Entity Type | Individual
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Provider Name | JONATHAN ALEXANDER CHURCH MD
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Gender | Male
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 209 N BONNIE BRAE ST STE 200
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City | DENTON
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State | TX
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Zip | 76201-3748
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Country | US
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Telephone | 940-281-1221
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Fax |
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Provider Business Mailing Address
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Address Line | 209 N BONNIE BRAE ST STE 200
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City | DENTON
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State | TX
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Zip | 76201-3748
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Country | US
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Telephone | 940-281-1221
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036.148057
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | S5584
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 036.148057
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | S5584
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License Number State | TX
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