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Individual

MR. ANTHNOY SHADE JONES III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LV.N.

Contact information

Practice address
414 NAVARRO ST, SAN ANTONIO, TX 78205-2516
(210) 589-2265
Mailing address
2224 OAK PL, SCHERTZ, TX 78154-1827
(210) 589-2265

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
159307
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
159307
LVN CERTIFICATION NUMBER
TX
Enumeration date
03/28/2014
Last updated
03/28/2014
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