Provider Demographics
NPI:1235461534
Name:ENCARNACION, JEAN I (PA-C)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:I
Last Name:ENCARNACION
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9494 SW FWY
Mailing Address - Street 2:#600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1419
Mailing Address - Country:US
Mailing Address - Phone:713-596-8500
Mailing Address - Fax:713-596-8560
Practice Address - Street 1:15400 SOUTHWEST FWY
Practice Address - Street 2:#125
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3875
Practice Address - Country:US
Practice Address - Phone:281-242-0131
Practice Address - Fax:281-242-7402
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-07-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA06086363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L26050Medicare PIN