Provider Demographics
NPI:1437431657
Name:DURON, JOSE JR
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:
Last Name:DURON
Suffix:JR
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 1:15822 PLEASANT WELL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-0000
Mailing Address - Country:US
Mailing Address - Phone:210-823-0656
Mailing Address - Fax:210-593-1518
Practice Address - Street 1:4319 MEDICAL DR
Practice Address - Street 2:SUITE 213
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3381
Practice Address - Country:US
Practice Address - Phone:210-593-0098
Practice Address - Fax:210-593-1518
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP 13758247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other