Provider Demographics
NPI:1386247773
Name:SAYON, JIMERE JONTELLE
Entity type:Individual
Prefix:
First Name:JIMERE
Middle Name:JONTELLE
Last Name:SAYON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8332 CHASEMONT CT
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-3860
Mailing Address - Country:US
Mailing Address - Phone:210-371-2140
Mailing Address - Fax:
Practice Address - Street 1:5121 CRESTWAY RD STE 200B
Practice Address - Street 2:
Practice Address - City:WINDCREST
Practice Address - State:TX
Practice Address - Zip Code:78239-1975
Practice Address - Country:US
Practice Address - Phone:210-310-3864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX308648164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse