Individual
DR. JASON EVERETT DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L1558
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145224503
MEDICAID PROVIDER ID
TX
01
—
L1558
LICENSE NUMBER
TX
Enumeration date
10/04/2005
Last updated
05/23/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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