Provider Demographics
NPI:1649663857
Name:DAVID R JONES M.D.,P.A.
Entity type:Organization
Organization Name:DAVID R JONES M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIRSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-883-5300
Mailing Address - Street 1:3070 COLLEGE ST
Mailing Address - Street 2:SUITE 406
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4691
Mailing Address - Country:US
Mailing Address - Phone:409-883-5300
Mailing Address - Fax:409-883-5394
Practice Address - Street 1:3070 COLLEGE ST
Practice Address - Street 2:SUITE 406
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4691
Practice Address - Country:US
Practice Address - Phone:409-883-5300
Practice Address - Fax:409-883-5394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ42392081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB146780OtherMEDICARE INDIVIDUAL PTAN
TXTXB146779OtherMEDICARE GROUP PTAN
TX6742360002OtherDME PTAN BEAUMONT