Provider Demographics
NPI:1124153341
Name:ARMANDO J. JARQUIN, MD, PA
Entity type:Organization
Organization Name:ARMANDO J. JARQUIN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:JARQUIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-599-8345
Mailing Address - Street 1:PO BOX 57
Mailing Address - Street 2:
Mailing Address - City:BARKER
Mailing Address - State:TX
Mailing Address - Zip Code:77413-0057
Mailing Address - Country:US
Mailing Address - Phone:281-599-8345
Mailing Address - Fax:281-599-3030
Practice Address - Street 1:705 S FRY RD STE 105
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2252
Practice Address - Country:US
Practice Address - Phone:281-599-8345
Practice Address - Fax:281-599-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6835173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1519928Medicaid
TX1519928Medicaid
TX8802B0Medicare ID - Type Unspecified