Individual
JARED ROBERT SISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
911 W 38TH ST STE 300, AUSTIN, TX 78705-1161
(512) 439-1000
Mailing address
507 VIRGINIA DR, ROUND ROCK, TX 78664-3048
(512) 915-0538
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
029543
NY
363AM0700X
Medical Physician Assistant
PA18209
TX
363AS0400X
Surgical Physician Assistant
Primary
PA18209
TX
Other
Enumeration date
03/01/2023
Last updated
12/23/2024
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