JASPER DIAGNOSTIC CLINIC NPI 1801075957

NPI Information

NPI: 1801075957
Provider Name: JASPER DIAGNOSTIC CLINIC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 45D0940125

Address:
300 MARVIN HANCOCK DR
JASPER, TX
ZIP 75951
Phone: (409) 383-1355
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JASPER DIAGNOSTIC CLINIC is a primary care clinic center in Jasper, TX. JASPER DIAGNOSTIC CLINIC NPI is 1801075957. The provider is registered as an organization entity type.

The provider's business location address is:

300 MARVIN HANCOCK DR
JASPER, TX
ZIP 75951-480
Phone: (409) 383-1355
Fax: (409) 384-7276

The provider's authorized official is Saurabh Singh .
The authorized official title is Owner and has the following contact phone number (409) 383-1355.

The CLIA number assigned to this NPI record is 45D0940125 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/25/2007 and was last updated on 10/25/2007.

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	261QP2300X	Clinic/Center	Primary Care	J4671	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00527R	MEDICARE PIN	TEXAS
2	1442428	MEDICAID	TEXAS

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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