Provider Demographics
NPI:1659353795
Name:JONES, DAVID C (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 847506
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7506
Mailing Address - Country:US
Mailing Address - Phone:512-396-2500
Mailing Address - Fax:512-396-7640
Practice Address - Street 1:1304 WONDER WORLD DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7532
Practice Address - Country:US
Practice Address - Phone:512-396-2500
Practice Address - Fax:512-396-7640
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH30822085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX920006017OtherRR MEDICARE
TX088414004Medicaid
TX088414005Medicaid
TX8C1845Medicare PIN
TX088414005Medicaid
TX920006017OtherRR MEDICARE
TX088414004Medicaid