Provider Demographics
NPI:1235452038
Name:LANEY, JARED A (MD, FNP)
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:A
Last Name:LANEY
Suffix:
Gender:M
Credentials:MD, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10622 BLUEGRASS POND
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-5321
Mailing Address - Country:US
Mailing Address - Phone:210-802-1791
Mailing Address - Fax:
Practice Address - Street 1:7703 FLOYD CURL DR # MC7736
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3901
Practice Address - Country:US
Practice Address - Phone:210-567-4292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX839966363LF0000X
TXU6282207P00000X
MDR184418363LF0000X
TX725736207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily