Provider Demographics
NPI:1730412396
Name:KONEMAN, JASON
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:KONEMAN
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 1:2004 BARNETT DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-6044
Mailing Address - Country:US
Mailing Address - Phone:512-221-1780
Mailing Address - Fax:512-503-0553
Practice Address - Street 1:2004 BARNETT DR
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-6044
Practice Address - Country:US
Practice Address - Phone:512-221-1780
Practice Address - Fax:512-503-0553
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102114183700000X
246Y00000X, 251E00000X, 246YC3302X, 174H00000X, 171M00000X, 172V00000X, 247200000X
260101030750018183700000X
TX172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No183700000XPharmacy Service ProvidersPharmacy Technician
No246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information
No251E00000XAgenciesHome Health
No246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based
No174H00000XOther Service ProvidersHealth Educator
No172V00000XOther Service ProvidersCommunity Health Worker
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102114OtherTEXAS STATE BOARD OF PHARMACY