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NPI Code Detail

MEDICARE: MS. JESSICA LEE BRUMBLE D.O.

MEDICARE: MS. JESSICA LEE BRUMBLE D.O.
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
1207R00000XInternal Medicine PhysicianW1932TX
2207R00000XInternal Medicine PhysicianDR0076186CO
3207R00000XInternal Medicine Physician0102205187VA

General Provider Information

NPI Number : 1639530314
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JESSICA LEE BRUMBLE D.O.
Provider Business Mailing Address
First Line : 6700 W IH 10
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78201-2009
Country : US
Telephone Number : 210-736-6700
Fax Number : 215-445-3676
Provider Business Practice Location Address
First Line : 6700 W IH 10
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78201-2009
Country : US
Telephone Number : 210-736-6700
Fax Number : 215-445-3676
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2016
Last Update Date : 06/03/2026

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