Provider Demographics
NPI:1972901361
Name:JONES, MICHAEL (DVM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:DR
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DVM
Mailing Address - Street 1:1404 NE BIG BEND TRL
Mailing Address - Street 2:
Mailing Address - City:GLEN ROSE
Mailing Address - State:TX
Mailing Address - Zip Code:76043-5020
Mailing Address - Country:US
Mailing Address - Phone:254-897-4339
Mailing Address - Fax:
Practice Address - Street 1:1404 NE BIG BEND TRL
Practice Address - Street 2:
Practice Address - City:GLEN ROSE
Practice Address - State:TX
Practice Address - Zip Code:76043-5020
Practice Address - Country:US
Practice Address - Phone:254-897-4339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4537174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4537OtherVETERINARIAN