Jaaca Management Services LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M3109 Issued in TX

Legal business name

JAACA MANAGEMENT SERVICES LLC

Practice address

5505 New Copeland Rd
Tyler, TX 75703-3955

Phone

(903) 521-9861

NPI assigned

Sep 20, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Sanford E Watkins, MD

Title

Owner

Phone

(903) 521-9861

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1861828956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6008",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757116008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 NEW COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033955",
            "telephone_number": "903-521-9861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAACA MANAGEMENT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "SANFORD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-521-9861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M3109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1992781090",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ivie Izekor, MD
• J. David Johnson,MD,PA
• J. L. Miguez, Inc., Dba Newsound Hearing Centers
• J. Scott Ellis, D.D.S.
• J. Stuart Crutchfield, M.D.,P.a.
• Jaaca Medical
• Ashlyn Jacinto, SLP
• Kimberly Estella Jacinto, DDS
• Jack Jones Hearing Centers, Inc
• John Daniel Jackman, MD

• Internal Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.