Provider Demographics
NPI:1356402937
Name:JONES, RICHARD W JR (CNRN,RNFA)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:W
Last Name:JONES
Suffix:JR
Gender:M
Credentials:CNRN,RNFA
Other - Prefix:
Other - First Name:RICH
Other - Middle Name:W
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNRN,RNFA
Mailing Address - Street 1:6822 PLUM CREEK DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-1601
Mailing Address - Country:US
Mailing Address - Phone:806-373-3177
Mailing Address - Fax:806-373-0423
Practice Address - Street 1:6822 PLUM CREEK DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-1601
Practice Address - Country:US
Practice Address - Phone:806-373-3177
Practice Address - Fax:806-373-0423
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX244991363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00141164OtherRAILROAD MEDICARE
TXP00141164OtherRAILROAD MEDICARE