Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | L6444 | TX |
N | 2080A0000X | Adolescent Medicine | L6444 | TX |
NPI | 1275751893 |
---|---|
Provider Name | Sarah Lynn Jones |
First Address | Austin, TX 78755-0726 |
Second Address | Austin, TX 78748-6208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 28/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
157910403 | (05) | TX |
157910404 | (05) | TX |
BJ8339043 | DEA (01) | TX |
I26380 | (02) | TX |
L6444 | PHYSICIANS PERMIT (01) | TX |