Individual
JERROD ALAN TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
200 COUNTY ROAD 340A, BLDG II, SUITE B-C, BURNET, TX 78611-4537
(830) 693-2600
(830) 693-9755
Mailing address
PO BOX 1219, BURNET, TX 78611-7219
(512) 715-3114
(512) 715-3116
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
12/02/2009
Last updated
07/07/2016
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