Provider Demographics
NPI:1396445375
Name:SOUFFRANT, JEAN
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:SOUFFRANT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5114 BALCONES WOODS DR STE 307-382
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5273
Mailing Address - Country:US
Mailing Address - Phone:617-943-9331
Mailing Address - Fax:
Practice Address - Street 1:5114 BALCONES WOODS DR STE 307-382
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5273
Practice Address - Country:US
Practice Address - Phone:617-943-9331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion