Provider Demographics
NPI:1699779348
Name:HUBBARD, JASON C (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:C
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1749 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-3043
Mailing Address - Country:US
Mailing Address - Phone:325-646-9900
Mailing Address - Fax:
Practice Address - Street 1:919 EARLY BLVD STE 1C
Practice Address - Street 2:
Practice Address - City:EARLY
Practice Address - State:TX
Practice Address - Zip Code:76802-2208
Practice Address - Country:US
Practice Address - Phone:325-646-9900
Practice Address - Fax:325-641-3109
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4978207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00108951OtherRR MEDICARE #
TX8M7060OtherBCBS IND #
TX153813408Medicaid
TXH72169Medicare UPIN
TX8B9129Medicare PIN