Provider Demographics
NPI:1922813104
Name:JARVIS, CAITLIN R (PA)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:R
Last Name:JARVIS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:901 MONTREUX AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7289
Mailing Address - Country:US
Mailing Address - Phone:256-975-2491
Mailing Address - Fax:
Practice Address - Street 1:901 MONTREUX AVE
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-7289
Practice Address - Country:US
Practice Address - Phone:256-975-2491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant