MEDICARE: DR. JASON M KOLODJSKI DC, FNP-C

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	111N00000X	Chiropractor	7233	TX
2	363LF0000X	Family Nurse Practitioner	AP131563	TX

General Provider Information

NPI Number	:	1821110545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON M KOLODJSKI DC, FNP-C

Provider Business Mailing Address
First Line	:	13384 JONES RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-3916
Country	:	US
Telephone Number	:	281-897-8818
Fax Number	:	281-897-8817

Provider Business Practice Location Address
First Line	:	13384 JONES RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-3916
Country	:	US
Telephone Number	:	281-897-8818
Fax Number	:	281-897-8817

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	06/06/2021

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