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NPI Code Detail

MEDICARE: JARRED ALICEA

MEDICARE: JARRED ALICEA
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
1247100000XRadiologic TechnologistGMR02011530TX

General Provider Information

NPI Number : 1215866611
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARRED ALICEA
Provider Business Mailing Address
First Line : 217 BRIARCLIFF DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78213-1936
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15 WALLER ST
Second Line :
City : AUSTIN
State : TX
Zip : 78702-5240
Country : US
Telephone Number : 512-972-5460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2026
Last Update Date : 05/21/2026

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Directions to “ JARRED ALICEA ” Practice Location

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