Provider Demographics
NPI:1093832156
Name:JON OUSLEY AND ASSOCIATES
Entity Type:Organization
Organization Name:JON OUSLEY AND ASSOCIATES
Other - Org Name:JUST FOR KIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-351-9700
Mailing Address - Street 1:1710 W HIGHWAY 287 BUSINESS
Mailing Address - Street 2:SUITE 140
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-4732
Mailing Address - Country:US
Mailing Address - Phone:972-351-9700
Mailing Address - Fax:972-351-9119
Practice Address - Street 1:1710 W HIGHWAY 287 BUSINESS
Practice Address - Street 2:SUITE 140
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-4732
Practice Address - Country:US
Practice Address - Phone:972-351-9700
Practice Address - Fax:972-351-9119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83461223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty