Provider Demographics
NPI:1326476193
Name:PATSY JONES MD, PA
Entity Type:Organization
Organization Name:PATSY JONES MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-472-9664
Mailing Address - Street 1:2113 E MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:106
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-1357
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2113 E MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:106
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-1357
Practice Address - Country:US
Practice Address - Phone:512-472-9664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4132261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00027MOtherMEDICARE IDENTIFICATION NUMBER
TXC17597Medicare UPIN