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NPI Code Detail

MEDICARE: AINSLEY JETER PA

MEDICARE: AINSLEY JETER PA
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
1363A00000XPhysician AssistantPA20005TX

General Provider Information

NPI Number : 1538027123
Entity Type Code : Individual
Provider Name (Legal Business Name) : AINSLEY JETER PA
Provider Business Mailing Address
First Line : 400 S SAINT PAUL ST APT 1307
Second Line :
City : DALLAS
State : TX
Zip : 75201-5547
Country : US
Telephone Number : 817-255-1152
Fax Number :
Provider Business Practice Location Address
First Line : 4401 BOOTH CALLOWAY RD
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-7371
Country : US
Telephone Number : 817-255-1152
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2026
Last Update Date : 02/18/2026

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Directions to “ AINSLEY JETER PA” Practice Location

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