Individual
JASON DOUGLAS SOARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 606-4262
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02839
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
360386205
—
TX
01
—
8ME166
BCBS
TX
01
—
909620
MEDICARE
TX
Enumeration date
07/24/2006
Last updated
04/09/2020
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