DR. JAMIE LYNN JAQUA MD NPI 1639360811

NPI Information

NPI: 1639360811
Provider Name: DR. JAMIE LYNN JAQUA, MD
Classification: Pediatrics - 2080P0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
520 MADISON OAK DR
SAN ANTONIO, TX
ZIP 78258
Phone: (210) 297-4050
Get Directions

DR. Jamie Lynn Jaqua, MD is a pediatric emergency medicine pediatrics in San Antonio, TX. The provider is a pediatrician who has special qualifications to manage emergencies in infants and children. DR. Jamie Lynn Jaqua, MD NPI is 1639360811. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

520 MADISON OAK DR
SAN ANTONIO, TX
ZIP 78258-912
Phone: (210) 297-4050

The NPI 1639360811 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/5/2007 and was last updated on 6/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080P0204X	Pediatrics	Pediatric Emergency Medicine	2010-01200	NORTH CAROLINA	No
2	2080P0204X	Pediatrics	Pediatric Emergency Medicine	P6362	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5920138	MEDICAID	NORTH CAROLINA
2	4661837281	OTHER		MYUTMB 4661837281

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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