Provider Demographics
NPI:1285185843
Name:JONES, CRISTIE ELAINE (AUD)
Entity Type:Individual
Prefix:
First Name:CRISTIE
Middle Name:ELAINE
Last Name:JONES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 E HIGHWAY 290
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4100 EVERETT DR
Practice Address - Street 2:SUITE 400
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6146
Practice Address - Country:US
Practice Address - Phone:512-295-1333
Practice Address - Fax:512-406-7327
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51571231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX366732101Medicaid
TX366732102Medicaid
TXP01782995Medicare PIN
TX549022YKXVMedicare PIN
TX366732101Medicaid