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Individual

JASON D LAYNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
703 S FLEISHEL AVE, STE 4000, TYLER, TX 75701-2015
(903) 606-7000
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04135
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
184588501
TX
05
184588502
TX
01
8N8269
BCBS OF TEXAS
Enumeration date
08/18/2005
Last updated
01/07/2015
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