Individual
JERRY KULANGARA JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1615 HOSPITAL PKWY STE 306, BEDFORD, TX 76022-5936
(512) 628-0465
Mailing address
7300 RANCH ROAD 2222, BLDG 1, STE 200, AUSTIN, TX 78730-3255
(512) 628-0465
(512) 233-2711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2022
Last updated
08/18/2023
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