Jaqua, Jamie Lynn

Jaqua, Jamie Lynn is an individual health care provider with primary practice located at 520 Madison Oak Dr , San Antonio TX 78258-3912. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Jaqua, Jamie Lynn can be contacted via phone (210) 297-4050.

Contact Information

Primary practice address
520 Madison Oak Dr San Antonio TX 78258-3912
Phone: (210) 297-4050
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X P6362 Texas
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X P6362 Texas
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 2010-01200 North Carolina

Profile Details

NPI number 1639360811
LBN Legal business name Jaqua, Jamie Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2007
Last updated Mar 12th, 2024 - about 6 months 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 1639360811 NPPES
Other 4661837281 MYUTMB 4661837281
MEDICAID 5920138 MYUTMB 4661837281

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