Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | D5411 | TX |
NPI | 1891852117 |
---|---|
Provider Name | Dr. David Garfield Jones |
First Address | Austin, TX 78748 |
Second Address | Austin, TX 78748-5371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 11/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A34809 | (02) | |
AJ7738773 | DEA (01) | |
XJ7338773 | XDEA (01) |