Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB DANIEL ETHRIDGE, PA
ActiveJACOB DANIEL ETHRIDGE, PA is a Physician Assistant healthcare provider located in SAN ANTONIO, Texas. NPI 1104301852 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · SAN ANTONIO, TX
Registration Details
- NPI Number
- 1104301852
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 28, 2018 (7.8335202710284 yrs)
- Last Updated
- Jun 29, 2022
- Licenses
-
TEMPORARY (TX)PA12348 (TX)
Practice Information
- Address
-
1150 N LOOP 1604 W STE 150SAN ANTONIO, TX, 782484505Browse TX providers · Browse ZIP 78248
- Phone
- 2817838162
- Fax
- 7134397995
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in SAN ANTONIO, TX
| Name | Credential | NPI |
|---|---|---|
| MICHAEL EDWARD CHAMPION | PA | 1558364018 |
| VANESSA N BECKER | PA-C | 1861496440 |
| ECHO J WALBY | PA-C | 1003810680 |
| MR. LARRY GENE PIZZOLA | PA-C | 1679577308 |
| ALITZA K FORD | PA-C | 1356346886 |
| MR. HASEEB ALI | PA | 1538168299 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.