Provider Demographics
NPI:1366445538
Name:JONES, RONALD W (DO)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:W
Last Name:JONES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 758
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-0758
Mailing Address - Country:US
Mailing Address - Phone:972-636-9577
Mailing Address - Fax:
Practice Address - Street 1:200 N. ARCH ST.
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-0758
Practice Address - Country:US
Practice Address - Phone:972-636-9577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3716207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F9824OtherMEDICARE ID-TYPE UNSPECIFIED
TX111472001Medicaid
TXA67211Medicare UPIN