Individual
JEAN HASSKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3514 21ST ST FL 6, LUBBOCK, TX 79410
(806) 725-2263
(806) 723-7768
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00234
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E6064
—
NM
01
—
207773100
FIRSTCARE
TX
05
—
286620401
—
TX
01
—
899N88
BCBS
TX
01
—
P01059324
RAILROAD MEDICARE
TX
01
—
TXB139806
MEDICARE
TX
Enumeration date
08/01/2011
Last updated
09/04/2018
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