MEDICARE: DR. ROBERTA J JONES M.D.

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	2084P0800X	Psychiatry Physician	K2929	TX

General Provider Information

NPI Number	:	1609957547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERTA J JONES M.D.

Provider Business Mailing Address
First Line	:	12274 BANDERA RD STE 212
Second Line	:
City	:	HELOTES
State	:	TX
Zip	:	78023-4387
Country	:	US
Telephone Number	:	210-857-7979
Fax Number	:	210-344-9796

Provider Business Practice Location Address
First Line	:	12274 BANDERA RD STE 212
Second Line	:
City	:	HELOTES
State	:	TX
Zip	:	78023-4387
Country	:	US
Telephone Number	:	210-857-7979
Fax Number	:	210-344-9796

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	09/24/2010

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