Jordan H Graustark in Addison - Physician Assistant
Jordan H Graustark - NPI 1336187301
Jordan H Graustark is a Physician Assistant in Addison, Texas. Jordan H Graustark practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Jordan H Graustark is 1336187301. The last update date is 2015-08-06.
Jordan H Graustark's current location address is 5080 Spectrum Dr, Addison, Texas. You can contact this provider via phone number 9727207772 and fax number 2147754502. The mailing address for Jordan H Graustark is 5080 Spectrum Dr, Addison, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jordan H Graustark |
|---|---|
| Address | 5080 Spectrum Dr, Addison, Texas |
| Phone Number | 9727207772 |
| Fax Number | 2147754502 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1336187301 |
|---|---|
| Provider Enumeration Date | 2006-06-03 |
| Last Updated Date | 2015-08-06 |
Provider Mailing Address Detail
| Address | 5080 Spectrum Dr |
|---|---|
| City | Addison |
| State | Texas (TX) |
| Post Code | 750014648 |
| Phone Number | 9727207772 |
| Fax Number | 2147754502 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 0204P |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 30331233 | NH | -- | |
| 3081765 | NH | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Jordan H Graustark by the Centers for Medicare & Medicaid Services?
The Jordan H Graustark has been assigned the NPI (National Provider Identifier) 1336187301 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete address where Jordan H Graustark is physically located?
The Jordan H Graustark is situated at the following address: 5080 Spectrum Dr, Addison, TX 750014648.
What is Jordan H Graustark's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jordan H Graustark's area of specialization is Physician Assistant, and the corresponding taxonomy code that categorizes this field of practice is 363A00000X.
When did Jordan H Graustark receive its 1336187301 assignment?
The Jordan H Graustark was assigned its 1336187301 on 2006-06-03, which is the date when this unique identifier was issued to the organization.
When was the information regarding Jordan H Graustark, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Jordan H Graustark, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2015-08-06.
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