Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | N1256 | TX |
NPI | 1407050347 |
---|---|
Provider Name | Jason Scott Ashford |
First Address | Conroe, TX 77304-2808 |
Second Address | Conroe, TX 77304-2808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 04/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00J21A | GROUP MEDICARE NUMBER (01) | TX |
094010801 | GROUP MEDICAID NUMBER (01) | TX |
N1256 | TEXAS MEDICAL BOARD (01) | TX |