Provider Demographics
NPI:1942208095
Name:ZHAO, JASON MING (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:MING
Last Name:ZHAO
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 1:800 MCCULLOUGH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1625
Mailing Address - Country:US
Mailing Address - Phone:210-226-6169
Mailing Address - Fax:210-226-8365
Practice Address - Street 1:800 MCCULLOUGH AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1625
Practice Address - Country:US
Practice Address - Phone:210-226-6169
Practice Address - Fax:210-226-8365
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3204207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147561801OtherSUPERIOR HEALTH
TX8782N0OtherBLUE CROSS BLUE SHIELD
TX147561801Medicaid
TX742787908OtherPACIFICARE
TX180043314OtherRAILROAD MEDICARE
TX741916103NOtherHUMANA
TX147561801OtherCOMMUNITY FIRST
TX7990308OtherAETNA
TX7990308OtherAETNA
TX147561801Medicaid