Individual
JAY TAKATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 S MURCHISON ST, ATHENS, TX 75751-2662
(903) 677-3737
(903) 677-6014
Mailing address
115 S MURCHISON ST, ATHENS, TX 75751-2662
(903) 677-3737
(903) 677-6014
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
K7400
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031287801
—
TX
Enumeration date
09/28/2007
Last updated
07/06/2025
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