Provider Demographics
NPI:1003587742
Name:JONES, PAUL EDWARD
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:EDWARD
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 HIGHWAY 277 N
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:TX
Mailing Address - Zip Code:76950-2204
Mailing Address - Country:US
Mailing Address - Phone:325-387-2541
Mailing Address - Fax:
Practice Address - Street 1:417 HIGHWAY 277 N
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:TX
Practice Address - Zip Code:76950-2204
Practice Address - Country:US
Practice Address - Phone:325-387-2541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy