Organization
JACK L. EARLE, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL A EARLE MD (PRESIDENT)
(210) 656-6721
Entity
Organization
Contact information
Practice address
8715 VILLAGE DR, SUITE 600, SAN ANTONIO, TX 78217-5405
(210) 656-6721
(210) 655-4309
Mailing address
8715 VILLAGE DR, SUITE 600, SAN ANTONIO, TX 78217-5405
(210) 656-6721
(210) 655-4309
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00TT68
MEDICAR ID #
TX
Enumeration date
04/13/2007
Last updated
02/13/2008
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