Jacqueline E Bvlgari, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1045517

Practice address

221 3Rd St W BLDG 1040
Jbsa Randolph, TX 78150-4800

Phone

(808) 282-2080

NPI assigned

Dec 30, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline E King Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1437136439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2931 HARNEY PATH RM 247",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347674",
            "telephone_number": "808-282-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 3RD ST W BLDG 1040",
            "city": "JBSA RANDOLPH",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "808-282-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BVLGARI",
        "first_name": "JACQUELINE",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": "1045517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "KING",
            "middle_name": "E",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kassandra Beltz, PA-C
• Eun Jung NMN Berry, RDH
• Brian R Blanchard, O.D.
• Karen Bowman, M.D.
• Kimberly Livingston Broom, M.D.
• John D Carlson, MSW
• Raymond E Collier, PA-C
• Kelly Cooper, D.D.S.
• Michael Curtin, DPT,MS, OCS, FAAOMPT
• Jacob R Dybdahl, PT, DPT, FAAOMPT

• Medical Physician Assistant in Jbsa Randolph, TX
• Providers in Jbsa Randolph, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.