Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 42000396A | IN |
N | 213EG0000X | General Practice | 42000396A | IN |
N | 1223G0001X | General Practice | DS038116 | PA |
N | 213EG0000X | General Practice | DS038116 | PA |
Y | 1223P0221X | Pediatric Dentist | 27694 | TX |
NPI | 1053630228 |
---|---|
Provider Name | Jason Ashcroft |
First Address | Haslet, TX 76052-3605 |
Second Address | Haslet, TX 76052-3605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2010 |
Last Update Date | 10/02/2015 |