Provider Demographics
NPI:1346496908
Name:ROWRAY, JERROLD R
Entity Type:Individual
Prefix:
First Name:JERROLD
Middle Name:R
Last Name:ROWRAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-3222
Mailing Address - Country:US
Mailing Address - Phone:210-829-7438
Mailing Address - Fax:210-829-7439
Practice Address - Street 1:26222 RANCH RD 12
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-4903
Practice Address - Country:US
Practice Address - Phone:512-858-0300
Practice Address - Fax:512-585-2714
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50326237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist