Provider Demographics
NPI:1770519266
Name:TIMOTHY C. JONES
Entity type:Organization
Organization Name:TIMOTHY C. JONES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:C
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-551-1856
Mailing Address - Street 1:PO BOX 938
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76540-0938
Mailing Address - Country:US
Mailing Address - Phone:254-634-6999
Mailing Address - Fax:254-200-4090
Practice Address - Street 1:11797 SOUTH FWY
Practice Address - Street 2:STE 140
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7026
Practice Address - Country:US
Practice Address - Phone:817-551-1856
Practice Address - Fax:817-551-1737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0030LYOtherBLUE CROSS BLUE SHIELD
TX0030LYOtherBLUE CROSS BLUE SHIELD