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NPI Code Detail

MEDICARE: LAURA J JONES PA-C

MEDICARE: LAURA J JONES 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
1363A00000XPhysician AssistantPA00697TX

General Provider Information

NPI Number : 1881686939
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA J JONES PA-C
Provider Business Mailing Address
First Line : 1301 PENNSYLVANIA AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2122
Country : US
Telephone Number : 817-250-4906
Fax Number : 817-250-1815
Provider Business Practice Location Address
First Line : 1301 PENNSYLVANIA AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2122
Country : US
Telephone Number : 817-250-4906
Fax Number : 817-250-1815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 10/28/2015

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Directions to “ LAURA J JONES PA-C” Practice Location

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