Provider Demographics
NPI:1013977594
Name:JAFFE, JON E (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:E
Last Name:JAFFE
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 1:7802 LINDENWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1512
Mailing Address - Country:US
Mailing Address - Phone:512-658-9923
Mailing Address - Fax:888-959-1486
Practice Address - Street 1:7802 LINDENWOOD CIR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1512
Practice Address - Country:US
Practice Address - Phone:512-658-9923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2141207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B4703OtherBLUE SHIELD
TX930107112OtherRR/MEDICARE
TX1396335-21Medicaid
TX1396335-22OtherCSHCN
TX1396335-22OtherCSHCN
TX1396335-21Medicaid