1265667356 NPI number — RELIEF JONES, III, M.D., PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265667356 NPI number — RELIEF JONES, III, M.D., PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RELIEF JONES, III, M.D., PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265667356
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12227 HUEBNER RD
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78230-1236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-485-1488
Provider Business Mailing Address Fax Number:
210-485-1489

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12227 HUEBNER RD
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78230-1236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-485-1488
Provider Business Practice Location Address Fax Number:
210-485-1489
Provider Enumeration Date:
05/19/2009

Additional Information

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
RELIEF
Authorized Official Middle Name:
Authorized Official Title or Position:
MD/OWNER
Authorized Official Telephone Number:
210-485-1488

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  M4220 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2112401-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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