MEDICARE: JENNIFER SPROWLS 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
1	363AM0700X	Medical Physician Assistant	PA03325	TX

General Provider Information

NPI Number	:	1588777643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER SPROWLS PA

Provider Business Mailing Address
First Line	:	1 DOESKIN DR UNIT 1701
Second Line	:
City	:	BOERNE
State	:	TX
Zip	:	78006-8824
Country	:	US
Telephone Number	:	210-200-8446
Fax Number	:

Provider Business Practice Location Address
First Line	:	15900 LA CANTERA PKWY
Second Line	:	SUITE 20265
City	:	SAN ANTONIO
State	:	TX
Zip	:	78256-2422
Country	:	US
Telephone Number	:	210-314-4740
Fax Number	:

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	07/25/2012

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Directions to “ JENNIFER SPROWLS PA” Practice Location

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