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:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1336196641 | NPPES |
Texas | MEDICAID | 176552101 |
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