Active NPI
Jessica Reynolds Walter, P.A.-C
- Physician Assistant
- Tomball, TX
National Provider Identifier
1194091280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA07756
- Practice address
- 26500 Kuykendahl Rd
Tomball, TX 77375 - Phone
- (281) 516-7234
- NPI assigned
- Mar 22, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA07756 | TX | Primary |
Addresses
Primary practice location
26500 Kuykendahl Rd
Tomball, TX 77375
Mailing address
9214 Barnsford LN
Tomball, TX 77375-2218
Phone (240) 643-5008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA07756 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423440000000",
"number": "1194091280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9214 BARNSFORD LN",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773752218",
"telephone_number": "240-643-5008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26500 KUYKENDAHL RD",
"city": "TOMBALL",
"state": "TX",
"postal_code": "77375",
"telephone_number": "281-516-7234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTER",
"first_name": "JESSICA",
"middle_name": "REYNOLDS",
"name_prefix": "Ms.",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-22",
"last_updated": "2015-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA07756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tomball, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.