Individual
MR. JARED W BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
4700 SETON CENTER PKWY, STE 200, AUSTIN, TX 78759-5295
(512) 439-1000
(512) 439-1081
Mailing address
4700 SETON CENTER PKWY, STE 200, AUSTIN, TX 78759-5295
(512) 439-1000
(512) 439-1081
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1878
CO
363AS0400X
Surgical Physician Assistant
Primary
PA05744
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00690919
RAILROAD MEDICARE
TX
Enumeration date
07/31/2006
Last updated
11/20/2019
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