MEDICARE: STEVEN ANTHONY JAECKLE PA-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	363A00000X	Physician Assistant	PA14927	TX
2	363A00000X	Physician Assistant	017575	NY
3	363A00000X	Physician Assistant	PA1734	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881009579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN ANTHONY JAECKLE PA-C

Provider Business Mailing Address
First Line	:	6406 N IH 35 STE 2600
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78752-4337
Country	:	US
Telephone Number	:	512-465-4800
Fax Number	:	512-420-0118

Provider Business Practice Location Address
First Line	:	1779 E WHITESTONE BLVD BLDG 2
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-6934
Country	:	US
Telephone Number	:	512-652-0050
Fax Number	:	737-220-7850

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

Provider Enumeration Date	:	06/22/2014
Last Update Date	:	09/30/2025

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