Provider Demographics
NPI:1275658395
Name:AUSTRING, JERALYN LEE (APN)
Entity Type:Individual
Prefix:
First Name:JERALYN
Middle Name:LEE
Last Name:AUSTRING
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:JERA
Other - Middle Name:
Other - Last Name:REMSHARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:5012 US HWY 75, SUITE 300
Mailing Address - Street 2:ATTN BILLING
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-1249
Mailing Address - Country:US
Mailing Address - Phone:903-416-7544
Mailing Address - Fax:
Practice Address - Street 1:3126 W FM 120
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-1249
Practice Address - Country:US
Practice Address - Phone:903-416-7544
Practice Address - Fax:903-416-7545
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224613363LP2300X
TXAP106365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX191567001Medicaid
TX191567001Medicaid
TX191567001Medicaid