Jasper Family Medicine

NPI #1215194303 in Jasper, Texas

Provider Information

NPI Number: 1215194303
Entity Type: Organization
Organization Name: Jasper Family Medicine
Primary Specialty: Nurse Practitioner
Enumeration Date: May 18, 2008
Last Updated: Nov 14, 2008

Practice Location

Address: 150 W GIBSON ST
City: Jasper
State: Texas
ZIP Code: 75951-4936
Phone: (409) 384-1700

Authorized Official

Name: ELIZABETH ANN BENTON
Title: SOLE OWNER
Phone: (281) 220-7549

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Psychologist	103T00000X
Family Medicine	207Q00000X
Nurse Practitioner	363L00000X	Primary

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