Individual
KEITH EDWARD JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
110 MAGEE STREET, GROVETON, TX 75845
(936) 642-0841
(936) 642-0849
Mailing address
PO BOX 459, GROVETON, TX 75845-0459
(936) 642-0841
(936) 309-0086
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA03871
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203876201
—
TX
05
—
203876202
—
TX
Enumeration date
11/15/2007
Last updated
08/22/2022
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