Provider Demographics
NPI:1720429087
Name:STONE, JARED A (PA)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:A
Last Name:STONE
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:9301 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0806
Mailing Address - Country:US
Mailing Address - Phone:214-220-2468
Mailing Address - Fax:214-397-1551
Practice Address - Street 1:9301 N CENTRAL EXPY
Practice Address - Street 2:SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0806
Practice Address - Country:US
Practice Address - Phone:214-220-2468
Practice Address - Fax:214-397-1551
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2013-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA08496363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX311583YNRJMedicare PIN