Provider Demographics
NPI:1407024227
Name:WELCH, JONATHAN CHASE (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:CHASE
Last Name:WELCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2430 S IH 35 STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5921
Mailing Address - Country:US
Mailing Address - Phone:512-353-1300
Mailing Address - Fax:512-353-5135
Practice Address - Street 1:2430 S IH 35 STE 106
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5921
Practice Address - Country:US
Practice Address - Phone:512-353-1300
Practice Address - Fax:512-353-5135
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXTL2008207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742732278OtherTAX ID