Jacob Mayberry Assisting Services
Organization Active NPI Surgical Physician Assistant · Bridgeport, TX
NPI 1184950784 · NPPES record last updated Aug 19, 2014
Key facts
- NPI
- 1184950784
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- C080326A (TX)
- Legal business name
- JACOB MAYBERRY ASSISTING SERVICES
- Practice address
- 104 Blue Water Dr
Bridgeport, TX 76426-4336 - Phone
- (281) 463-6309
- Fax
- (281) 463-6835
- NPI assigned
- Nov 2, 2009
- Organization subpart
- No
Authorized official
- Name
- Jacob Mayberry, CFA
- Title
- Owner
- Phone
- (281) 463-6309
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant |
363AS0400X | C080326A | TX | Yes |
Addresses
Primary practice location
104 Blue Water Dr
Bridgeport, TX 76426-4336
Mailing address
PO Box 2201
Decatur, TX 76234-6158
Phone (281) 463-6309
Other providers in Bridgeport, TX
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- Amber Hussman
- Infinity Laboratories, LLC
- Gary Wayne Jessup
- Jon W Copeland DO PA
- K&H Dental PA
- William Leonard
- Monica Lee Lewis
All providers in Bridgeport, TX · Surgical Physician Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.