Provider Demographics
NPI:1346346228
Name:EAMES, JENNIFER R (PA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:EAMES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:RUTH WEEMS
Other - Last Name:BURK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2200 HICKORY ST # 16236
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2345
Mailing Address - Country:US
Mailing Address - Phone:325-670-1701
Mailing Address - Fax:
Practice Address - Street 1:117 ORANGE BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-6394
Practice Address - Country:US
Practice Address - Phone:832-561-1105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX03485363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84P323Medicare PIN
TXP68344Medicare UPIN