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General NPI Number Information
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NPI Number | 1700260924
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Entity Type | Individual
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Provider Name | JASON COUCH FNP
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Gender | Male
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 7142 SAN PEDRO AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78216-6254
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Country | US
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Telephone | 726-204-4745
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Fax | 855-618-2367
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Provider Business Mailing Address
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Address Line | 6101 BLUE LAGOON DR STE 200
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City | MIAMI
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State | FL
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Zip | 33126-3168
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Country | US
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Telephone | 407-533-6836
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Fax | 407-770-0661
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP128541
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License Number State | TX
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