Provider Demographics
NPI:1174715387
Name:JONES, DAVID (LAC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 RIDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2544
Mailing Address - Country:US
Mailing Address - Phone:727-437-2250
Mailing Address - Fax:
Practice Address - Street 1:911 E 2ND ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-4212
Practice Address - Country:US
Practice Address - Phone:727-437-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-11
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC000936171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist