Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 676839 | TX |
N | 363LC1500X | Nurse Practitioner - Community Health | 676839 | TX |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 676839 | TX |
NPI | 1003935032 |
---|---|
Provider Name | David Jones |
First Address | Lubbock, TX 79424-2525 |
Second Address | New Braunfels, TX 78130-4136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 22/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
676839 | FNP LICENSE NUMBER (01) | TX |
P000U6248 | (05) | TX |