Watson, Jerome Bradfield

Watson, Jerome Bradfield is an sole proprietor health care provider with primary practice located at 7209 Goldfinch Rd , Texarkana TX 75501-0227. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is his primary health care specialty. Watson, Jerome Bradfield can be contacted via phone (903) 334-8132.

Contact Information

Primary practice address
7209 Goldfinch Rd Texarkana TX 75501-0227
Phone: (903) 334-8132
Fax: (903) 334-8146
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP108606 Texas
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 605190 Texas

Profile Details

NPI number 1538162045
LBN Legal business name Watson, Jerome Bradfield
Credentials Gerontological Nurse Practitioner (GNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 30th, 2005
Last updated Jul 3rd, 2023 - about 2 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 1538162045 NPPES
Texas MEDICAID 029325001
Texas Other 500004259
Texas MEDICAID 29325004
Texas MEDICAID 160262762
Texas Other 5U081
Texas Other P00267929
Texas MEDICAID 145430758
Texas Other 500004259
Texas MEDICAID 029325002
Texas MEDICAID 100082540A
Texas Other 8D9579

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