Provider Demographics
NPI:1770640310
Name:SEARS, JONATHAN EDWARD (PA-C)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:EDWARD
Last Name:SEARS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 CIMARRON PARK LOOP
Mailing Address - Street 2:SUITE A
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-2800
Mailing Address - Country:US
Mailing Address - Phone:512-295-9300
Mailing Address - Fax:512-295-7300
Practice Address - Street 1:155 CIMARRON PARK LOOP
Practice Address - Street 2:SUITE A
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-2800
Practice Address - Country:US
Practice Address - Phone:512-295-9300
Practice Address - Fax:512-295-7300
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00995363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA00995OtherPHYSICIAN ASSISTANT
TXBO133136OtherDPS NUMBER
TXBO133136OtherDPS NUMBER