Individual
JASON LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16727 BLUE SHINE TRL, CYPRESS, TX 77433-2596
(512) 423-0013
Mailing address
16727 BLUE SHINE TRL, CYPRESS, TX 77433-2596
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
Q4182
TX
Other
Enumeration date
04/03/2012
Last updated
04/06/2016
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