Provider Demographics
NPI:1417460684
Name:MCMEANS, JASPER R (FNP)
Entity Type:Individual
Prefix:
First Name:JASPER
Middle Name:R
Last Name:MCMEANS
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8611 WATERS EDGE DR # 316
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-2169
Mailing Address - Country:US
Mailing Address - Phone:210-708-6603
Mailing Address - Fax:
Practice Address - Street 1:8611 WATERS EDGE DR APT 316
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-2171
Practice Address - Country:US
Practice Address - Phone:210-708-6603
Practice Address - Fax:210-708-6603
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135806363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily