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Individual

JASON M GILES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSFA, LSA

Contact information

Practice address
117 HIGHWAY 332 W STE J, SUITE 5 BOX 222, LAKE JACKSON, TX 77566-4022
(432) 230-5412
Mailing address
117 HIGHWAY 332 W STE J, SUITE 5 BOX 222, LAKE JACKSON, TX 77566-4022
(432) 230-5412

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
363AS0400X
Surgical Physician Assistant
Primary
SA00582
TX

Other

Enumeration date
11/01/2013
Last updated
10/28/2016
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