JACOB MAYBERRY ASSISTING SERVICES NPI 1184950784

NPI Information

NPI: 1184950784
Provider Name: JACOB MAYBERRY ASSISTING SERVICES
Classification: Physician Assistant - 363AS0400X
Entity Type: Organization

Specialization: Surgical

Address:
104 BLUE WATER DR
BRIDGEPORT, TX
ZIP 76426
Phone: (281) 463-6309
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JACOB MAYBERRY ASSISTING SERVICES is a surgical physician assistant in Bridgeport, TX. JACOB MAYBERRY ASSISTING SERVICES NPI is 1184950784. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

104 BLUE WATER DR
BRIDGEPORT, TX
ZIP 76426-336
Phone: (281) 463-6309
Fax: (281) 463-6835

The provider's authorized official is Jacob Mayberry .
The authorized official title is Owner and has the following contact phone number (281) 463-6309.

The enumeration date for this NPI number is 11/2/2009 and was last updated on 8/19/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	C080326A	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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