MEDICARE: ROBERT JONES

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	16382	TX
2	101Y00000X	Counselor	16382	TX

General Provider Information

NPI Number	:	1801588918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JONES

Provider Business Mailing Address
First Line	:	12370 POTRANCO RD STE 207
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-4261
Country	:	US
Telephone Number	:	213-327-6295
Fax Number	:

Provider Business Practice Location Address
First Line	:	12370 POTRANCO RD STE 207
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-4261
Country	:	US
Telephone Number	:	213-327-6295
Fax Number	:

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

Provider Enumeration Date	:	05/25/2023
Last Update Date	:	08/17/2023

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Directions to “ ROBERT JONES ” Practice Location

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