Provider Demographics
NPI:1609898089
Name:MORGAN, JASON L
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:L
Last Name:MORGAN
Suffix:
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 1:1306 S GARY AVE
Mailing Address - Street 2:
Mailing Address - City:MONAHANS
Mailing Address - State:TX
Mailing Address - Zip Code:79756-6206
Mailing Address - Country:US
Mailing Address - Phone:214-728-4212
Mailing Address - Fax:
Practice Address - Street 1:317 S ALLEN AVE
Practice Address - Street 2:
Practice Address - City:MONAHANS
Practice Address - State:TX
Practice Address - Zip Code:79756-4303
Practice Address - Country:US
Practice Address - Phone:432-943-4892
Practice Address - Fax:432-943-4892
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor