Maxwell, Jack A

Maxwell, Jack A is an individual health care provider with primary practice located at 3600 Fm 2181 Ste 100 , Hickory Creek TX 75065-7636. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Maxwell, Jack A can be contacted via phone (940) 497-2204.

Contact Information

Primary practice address
3600 Fm 2181 Ste 100 Hickory Creek TX 75065-7636
Phone: (940) 497-2204
Fax: (940) 321-4977
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G9368 Texas
Allopathic & Osteopathic Physicians / Sleep Medicine 207QS1201X 2869 Texas

Profile Details

NPI number 1679585087
LBN Legal business name Maxwell, Jack A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Feb 1st, 2012 - 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 1679585087 NPPES
Texas MEDICAID 124499802
Texas MEDICAID 124499806

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