Provider Demographics
NPI:1174640106
Name:VENN, JASON TODD
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:TODD
Last Name:VENN
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 1:10625 N COUNTY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3832
Mailing Address - Country:US
Mailing Address - Phone:972-668-9200
Mailing Address - Fax:972-668-9204
Practice Address - Street 1:10625 N COUNTY RD STE 200
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3832
Practice Address - Country:US
Practice Address - Phone:972-668-9200
Practice Address - Fax:972-668-9204
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor