Teacle, Jon C

Teacle, Jon C is an individual health care provider with primary practice located at 2803 Earl Rudder Fwy S Ste 103 , College Station TX 77845-6099. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Teacle, Jon C can be contacted via phone (979) 731-8888.

Contact Information

Primary practice address
2803 Earl Rudder Fwy S Ste 103 College Station TX 77845-6099
Phone: (979) 731-8888
Fax: (979) 731-8848
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA02372 Texas

Profile Details

NPI number 1174591242
LBN Legal business name Teacle, Jon C
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Aug 12th, 2015 - about 11 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 1174591242 NPPES
Texas MEDICAID 190253801
Texas Other 8Y2631

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