| Jaaca Management Services Llc | |
|
5505 New Copeland Rd Tyler TX 75703-3955 | |
| (903) 521-9861 | |
| Not Available |
| Full Name | Jaaca Management Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5505 New Copeland Rd, Tyler, Texas |
| Authorized Official Name and Position | Sanford E Watkins (OWNER) |
| Authorized Official Contact | 9035219861 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaaca Management Services Llc Po Box 6008 Tyler TX 75711-6008 Ph: () - | Jaaca Management Services Llc 5505 New Copeland Rd Tyler TX 75703-3955 Ph: (903) 521-9861 |
| NPI Number | 1861828956 |
|---|---|
| Provider Enumeration Date | 09/20/2013 |
| Last Update Date | 09/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861828956 | NPI | - | NPPES |
| 1992781090 | Other | TX | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M3109 (Texas) | Primary |
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