1447261029 NPI number — WENDELL EMMETT HARRISON JONES MD MBA

Table of content: WENDELL EMMETT HARRISON JONES MD MBA (NPI 1447261029)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447261029 NPI number — WENDELL EMMETT HARRISON JONES MD MBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
WENDELL
Provider Middle Name:
EMMETT HARRISON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD MBA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1447261029
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2301 E LAMAR BLVD
Provider Second Line Business Mailing Address:
STE 650
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-652-1111
Provider Business Mailing Address Fax Number:
817-385-7700

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2301 E LAMAR BLVD
Provider Second Line Business Practice Location Address:
STE 650
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-652-1111
Provider Business Practice Location Address Fax Number:
817-385-7700
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  K7035 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: ME49484 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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