Provider Demographics
NPI:1467595553
Name:MICHAEL E JONES MD PA
Entity Type:Organization
Organization Name:MICHAEL E JONES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROXIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-774-1500
Mailing Address - Street 1:1121 BRIARCREST DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2505
Mailing Address - Country:US
Mailing Address - Phone:979-774-1500
Mailing Address - Fax:979-774-7160
Practice Address - Street 1:1121 BRIARCREST DR
Practice Address - Street 2:SUITE 303
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2505
Practice Address - Country:US
Practice Address - Phone:979-774-1500
Practice Address - Fax:979-774-7160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140299208Medicaid
TX140299236OtherMEDICAID TEXAS HEALTHSTEP
TX140299208Medicaid
TX00B55CMedicare ID - Type Unspecified