STEPHANIE JASIK (NPI# 1396992079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396992079 |
| Entity Type | Individual |
| Full Name | STEPHANIE JASIK |
| Credential | PA-C |
| Practice Address |
1110 N Sarah Dewitt Dr Gonzales TX 78629-3311 |
| Mailing Address |
Po Box 587 Gonzales TX 78629-0587 |
| Practice Telephone | 8306728502 |
| Practice Fax Number | 8306723035 |
| Mailing Telephone | 8306728502 |
| Mailing Fax Number | 8306723035 |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA05048 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 321101302 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2501 W William Cannon Dr, Suite 401, Austin, TX 787455281 | 5124167246 | 5122752833 |
| Street Address |
1110 N SARAH DEWITT DR |
| City | GONZALES |
| State | TX |
| Zip Code | 78629-3311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376547919 | Humberto Rivas | Pediatrics | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2005-06-10 |
| 1649744301 | Terry Matthew Clay | Physical Therapist | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2019-01-16 |
| 1790283596 | Diana Marie Mikulencak-picha | Registered Nurse | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2018-01-26 |
| 1700231396 | Michael Mikesh | Physical Therapist | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2016-05-02 |
| 1285088377 | Steven Poteet | Physical Therapist | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2016-04-15 |
| 1255799755 | Karen Fortune | Speech-Language Pathologist | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2016-01-29 |
| 1538527031 | Sheryl Breitschopf | Occupational Therapist | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2016-01-29 |
| 1932566577 | Sandra Johnston | Social Worker | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2016-01-27 |
| 1922465533 | Brittany Hill | Physical Therapist | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2016-01-27 |
| 1164840955 | Rikki Desiree Baldwin | Obstetrics & Gynecology | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2014-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265032072 | Bruce Franklin Blackwell | Pharmacist | 1114 East Sarah Dewitt Drive, Gonzales, TX 78629 | 2020-10-30 |
| 1790327765 | Gonzales County Emergency Services District 1 | Ambulance | 305 Qualls Street, Gonzales, TX 78629 | 2019-10-11 |
| 1831663400 | Caitlin Walker | Clinic/Center | 1300 Captain Albert Martin Trail, Gonzales, TX 78629 | 2019-01-17 |
| 1497251698 | Vaz Urgent Care Clinic, Pa | Clinic/Center | 1003 N Sarah Dewitt Drive, Gonzales, TX 78629 | 2018-04-05 |
| 1104348762 | Jeremiah Berryhill | Specialist/Technologist | 1711 E Sarah Dewitt Dr., Gonzales, TX 78629 | 2017-07-14 |
| 1073912861 | Gonzales County Senior Citizens Association, Inc | Home Delivered Meals | 818 Seydler Street, Gonzales, TX 78629 | 2014-08-18 |
| 1932544517 | Familylink Treatment Services | Counselor | 13326 Highway North 183, Gonzales, TX 78629 | 2013-05-08 |
| 1598035651 | H-e-b, Lp | Clinical Medical Laboratory | 1841 Church St., Gonzales, TX 78629 | 2012-01-06 |
| 1942441159 | Rebecca P. Bohach | Licensed Vocational Nurse | 228 St. George, Community Health Centers of South Central Texas, Inc, Gonzales, TX 78629 | 2009-03-18 |
| 1376763631 | Gonzales Isd | Local Education Agency (LEA) | 535 Fair St., Gonzales, TX 78629 | 2007-04-27 |
| Find all providers in zip 78629 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467914481 | Hajar Nomura Sakhi | Physician Assistant | 850 5th St, Gonzales, CA 93926-9491 | 2019-04-01 |
| 1407197114 | Kelly Gibson | Physician Assistant | 228 Saint George St, Gonzales, TX 78629-3910 | 2013-03-05 |
| 1881741346 | Mandy Moreno Micheaux | Physician Assistant | 228 Saint George St, Gonzales, TX 78629-3910 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704576 | Leila Olive Adell | Physician Assistant | 1221 S Congress Ave Apt 331, Austin, TX 78704-2461 | 2020-09-10 |
| 1619591864 | Today Telemedicine Pllc | Physician Assistant | 404 Oxford St Apt 2219, Houston, TX 77007-2679 | 2020-06-03 |
| 1497384168 | Gregory C Etienne | Physician Assistant | 7400 N 4th St, Mcallen, TX 78504-1859 | 2020-04-05 |
| 1689202475 | Theodore Inthaphom | Physician Assistant | 25222 Northwest Fwy Apt 349, Cypress, TX 77429-1065 | 2020-03-29 |
| 1740816982 | Alyssa Conrad | Physician Assistant | 4818 Star Jasmine Dr, Austin, TX 78723-6059 | 2020-03-19 |
| 1114558335 | Erin Lynn Brown | Physician Assistant | 1504 Taub Loop Houston, Houston, TX 77030 | 2020-01-27 |
| 1245870930 | Jessica Grimaldo | Physician Assistant | 1200 Brooklyn Ave Ste 230, San Antonio, TX 78212-0010 | 2020-01-09 |
| 1730728528 | Holli Marie Beard | Physician Assistant | 2625 Scripture St Ste 101, Denton, TX 76201-2304 | 2019-12-27 |
| 1477191237 | Ronald Edwin Brown | Physician Assistant | 1427 Cypress Point Dr, Gunter, TX 75058-3201 | 2019-12-11 |
| 1053957910 | Rossalya Aracely Granda Gutierrez | Physician Assistant | 4150 N Collins St, Arlington, TX 76005-4547 | 2019-11-25 |
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| 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.