MEDICARE: JASON CAMERON BRIGGS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1134408370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON CAMERON BRIGGS

Provider Business Mailing Address
First Line	:	4801 FARNAM ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68132-3224
Country	:	US
Telephone Number	:	402-517-5132
Fax Number	:

Provider Business Practice Location Address
First Line	:	4901 CALHOUN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-2612
Country	:	US
Telephone Number	:	402-517-5132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2011
Last Update Date	:	08/05/2011

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Directions to “ JASON CAMERON BRIGGS ” Practice Location

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