Provider Demographics
NPI:1124712138
Name:FRAME, JASON LEE JR (CPSW)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:LEE
Last Name:FRAME
Suffix:JR
Gender:M
Credentials:CPSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:SOCORRO
Mailing Address - State:NM
Mailing Address - Zip Code:87801-4559
Mailing Address - Country:US
Mailing Address - Phone:575-838-0998
Mailing Address - Fax:575-838-0244
Practice Address - Street 1:100 6TH ST S
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:NM
Practice Address - Zip Code:87801-4139
Practice Address - Country:US
Practice Address - Phone:505-865-4140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist