Bazan, Jennifer A

Bazan, Jennifer A is an individual health care provider with primary practice located at 8400 N Mopac Expy Suite 302, Austin TX 78759-8328. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Bazan, Jennifer A can be contacted via phone (512) 213-2388.

Contact Information

Primary practice address
8400 N Mopac Expy Suite 302 Austin TX 78759-8328
Phone: (512) 213-2388
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 19844 Texas

Profile Details

NPI number 1336196641
LBN Legal business name Bazan, Jennifer A
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2006
Last updated Dec 1st, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336196641 NPPES
Texas MEDICAID 176552101

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