Organization
ST JOSEPH PHYSICIAN ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN ALEXANDER FRIEDMAN M.D. (PHYSICIAN)
(979) 776-8896
Entity
Organization
Contact information
Practice address
2601 OSLER BLVD, BRYAN, TX 77802-2516
(979) 776-5960
(979) 776-2129
Mailing address
2601 OSLER BLVD, BRYAN, TX 77802-2516
(979) 776-5960
(979) 776-2129
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207T00000X
Neurological Surgery Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0048NC
BLUE CROSS TEXAS GROUP #
TX
05
—
180488201
—
TX
01
—
DE4650
RAILROAD MEDICARE
—
Enumeration date
08/18/2006
Last updated
01/05/2012
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