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NPI Code Detail

MEDICARE: JONATHAN ADAMS

MEDICARE: JONATHAN ADAMS
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1679696322
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN ADAMS
Provider Business Mailing Address
First Line : PO BOX 1714
Second Line :
City : FORNEY
State : TX
Zip : 75126-1714
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 901 S ERVAY ST
Second Line :
City : DALLAS
State : TX
Zip : 75201-6419
Country : US
Telephone Number : 214-939-3933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 07/08/2007

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Directions to “ JONATHAN ADAMS ” Practice Location

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