JASON GOURLAS PA NPI 1750498754

NPI Information

  • NPI: 1750498754
  • Provider Name: JASON GOURLAS, PA
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4502 MEDICAL DR
    SAN ANTONIO, TX
    ZIP 78229
  • Phone: (210) 358-2078

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NPI Details

Jason Gourlas, PA is a surgical physician assistant in San Antonio, TX. Jason Gourlas, PA NPI is 1750498754. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4502 MEDICAL DR
SAN ANTONIO, TX
ZIP 78229-402
Phone: (210) 358-2078
Fax: (210) 358-1972

The NPI 1750498754 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 8/24/2006 and was last updated on 10/29/2014.

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
1363AS0400XPhysician AssistantSurgicalPA01671TEXASYes

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
1189458602MEDICAIDTEXAS
28L12297MEDICARE PINTEXAS
381N212MEDICARE PINTEXAS
4189458601MEDICAIDTEXAS

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: 11/21/2025

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