Squyres, Jonathan Ray

Squyres, Jonathan Ray is an sole proprietor health care provider with primary practice located at 130 Michaels Loop , Lufkin TX 75901-8317. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Squyres, Jonathan Ray can be contacted via phone (936) 824-5011.

Contact Information

Primary practice address
130 Michaels Loop Lufkin TX 75901-8317
Phone: (936) 824-5011
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 18907 Texas
Behavioral Health & Social Service Providers / Psychologist 103T00000X 38103 Texas

Profile Details

NPI number 1285629055
LBN Legal business name Squyres, Jonathan Ray
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 16th, 2005
Last updated Oct 11th, 2019 - about 6 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 1285629055 NPPES
Texas MEDICAID 174531702

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