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:
Health care specialties
| Specialty | Code | License # | 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 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639360811 | NPPES |
| Other | 4661837281 | MYUTMB 4661837281 | |
| MEDICAID | 5920138 | MYUTMB 4661837281 |
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