Individual
JASON MOMMAERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-1000
Mailing address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA17224
TX
363A00000X
Physician Assistant
Primary
PA5627
OK
363A00000X
Physician Assistant
PA62166
CA
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/24/2012
Last updated
03/02/2026
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