Provider Demographics
NPI:1962046888
Name:CARTER, JARED A (RN)
Entity type:Individual
Prefix:MR
First Name:JARED
Middle Name:A
Last Name:CARTER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 W IH 10 STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3149
Mailing Address - Country:US
Mailing Address - Phone:210-739-9470
Mailing Address - Fax:
Practice Address - Street 1:9100 W IH 10 STE 210
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3149
Practice Address - Country:US
Practice Address - Phone:210-928-3900
Practice Address - Fax:210-855-5974
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator