Provider Demographics
NPI:1487716999
Name:LAMOUREAUX, JON L (NP)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:L
Last Name:LAMOUREAUX
Suffix:
Gender:M
Credentials:NP
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8401 DATAPOINT DR
Mailing Address - Street 2:SUITE 700
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5900
Mailing Address - Country:US
Mailing Address - Phone:210-487-7463
Mailing Address - Fax:210-487-7468
Practice Address - Street 1:8401 DATAPOINT DR
Practice Address - Street 2:SUITE 700
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5900
Practice Address - Country:US
Practice Address - Phone:210-487-7463
Practice Address - Fax:210-487-7468
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2017-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP130747363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX500166AC2LOtherMEDICARE