JACK D RUNYAN


Address: 734 W Commerce St, Fairfield, TX 75840
Phone: 9565724000

JACK D RUNYAN (NPI# 1245476282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245476282
Entity Type Individual
Full Name JACK D RUNYAN
Credential PA, PHD
Practice Address 734 W Commerce St
Fairfield
TX 75840
Mailing Address 734 W Commerce St
Fairfield
TX 75840-1428
Practice Telephone 9565724000
Mailing Telephone 9033892181
Mailing Fax Number 9033890901
Enumeration Date 2008-12-22
Last Update Date 2018-08-07
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA 01154 TX Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 734 W COMMERCE ST
City FAIRFIELD
State TX
Zip Code 75840

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710986807 East Texas Medical Center Home Services Hospice Care, Community Based 734 W Commerce St, Fairfield, TX 75840-1406 2005-07-20
1184180044 Kayla Sierra Farmer Nurse Practitioner 734 W Commerce St, Fairfield, TX 75840-1428 2019-02-15
1316423452 Tonya N Basque Nurse Practitioner 734 W Commerce St, Fairfield, TX 75840 2018-07-12
1568987071 Stacy Ann Gallegos Nurse Practitioner 734 W Commerce St, Fairfield, TX 75840-1428 2017-08-04
1093263501 Fairfield Hospital District Clinic/Center 734 W Commerce St, Suite C, Fairfield, TX 75840-1428 2016-09-13
1871918565 Mark Waweru Family Medicine 734 W Commerce St, Fairfield, TX 75840-1428 2014-03-04
1366879694 Lora Kelly Brown Physician Assistant 734 W Commerce St, Fairfield, TX 75840-1428 2013-10-01
1427322585 Mary Elias Sorial Family Medicine 734 W Commerce St, Fairfield, TX 75840-1428 2012-03-06
1154316974 Darryl White Family Medicine 734 W Commerce St, Fairfield, TX 75840-1428 2005-09-19
1508859596 Joseph R Berger IIi Family Medicine 734 W Commerce St, Fairfield, TX 75840-1428 2005-08-25
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1811508724 Caitlin Nicole Sieck Physical Therapist 375 A West Hwy 84, Fairfield, TX 75840 2020-08-13
1841816014 Katie Randall Licensed Practical Nurse 115 Pr 1295, Fairfield, TX 75840 2020-06-23
1063574671 Rural Rehab Providers, LLC Physical Therapist 375-a West Hwy 84, Fairfield, TX 75840 2006-12-14
1598854572 Erin Maggard Specialist 375a W Hwy 84, Fairfield, TX 75840 2006-10-11
1003916453 Brookshire Brothers Inc Pharmacy 300 West Hwy 84, Fairfield, TX 75840 2006-09-25
1003899501 Air Evac Ems Inc Ambulance 160 Interstate 45 S, Fairfield, TX 75840 2005-11-29
1952681256 Suzanne Castles Physical Therapist 375-a West Hwy 84, Fairfield, TX 75840 2011-08-18
1407945488 Lisa Lott Nurse Practitioner 375a W Hwy 84, Fairfield, TX 75840 2006-10-11
1972692952 David Lott Physical Therapist 375a W Hwy 84, Fairfield, TX 75840 2006-10-11
1811973936 Brian J. Shultz Chiropractor 305 W Commerce St, Fairfield, TX 75840-1401 2005-12-20
Find all providers in zip 75840

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1225668205 Melissa Hisako Reagan Physician Assistant 1261 Travis Blvd Ste 100, Fairfield, CA 94533-4804 2020-01-18
1467639385 Akosua Rodriguez Physician Assistant 2720 Low Ct Fl 2, Fairfield, CA 94534-9771 2008-01-22
1215061775 Terrelyn C Fernandez Physician Assistant 1620 Pennsylvania Ave Ste C, Fairfield, CA 94533-3509 2007-03-15
1679618318 Jennifer Chapman Physician Assistant 1801 Fairfield Beach Rd, Fairfield, CT 06824-6524 2007-02-20
1336251610 Douglas K Casperson Physician Assistant 223 W Main, Ste A, Fairfield, MT 59436-6503 2006-08-31
1437142379 Kayla Shaye Bell Physician Assistant 213 Nw 11th Street, Suite A, Fairfield, IL 62837 2005-08-25
1629513270 Emily Elizabeth Helling Physician Assistant 2000 S Main St, Fairfield, IA 52556-9572 2017-01-05
1821546607 Danielle Marie Centone Physician Assistant 75 Kings Highway Cutoff, Fairfield, CT 06824-5340 2016-09-21
1629431002 Cassaundra Kalman Craig Physician Assistant 5390 Dixie Hwy, Fairfield, OH 45014-4124 2016-04-01
1457735540 Emily Woodall Physician Assistant 3000 Mack Rd, Fairfield, OH 45014-5335 2015-07-17
Find all providers in FAIRFIELD

Competitor

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City FAIRFIELD
Zip Code 75840

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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