Individual
JASON ALLEN FONDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3030 NORTH ST STE 430, BEAUMONT, TX 77702-1434
(409) 899-2500
Mailing address
3030 NORTH ST STE 430, BEAUMONT, TX 77702-1434
(409) 899-2500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10809
TX
Other
Enumeration date
10/25/2016
Last updated
12/07/2016
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