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General NPI Number Information
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NPI Number | 1750791240
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Entity Type | Individual
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Provider Name | NATHANIEL GREY JONES PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/06/2014
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Last Update Date | 02/19/2015
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Provider Practice Location Address
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Address Line | 1604 HOSPITAL PKWY STE 501
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City | BEDFORD
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State | TX
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Zip | 76022-6932
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Country | US
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Telephone | 817-684-2700
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Fax | 817-684-2709
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Provider Business Mailing Address
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Address Line | 1604 HOSPITAL PKWY STE 501
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City | BEDFORD
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State | TX
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Zip | 76022-6932
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Country | US
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Telephone | 817-684-2700
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Fax | 817-684-2709
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA09140
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License Number State | TX
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