Provider Demographics
NPI:1679611032
Name:BAUM-JONES, AMY (PA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BAUM-JONES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4471 LONG PRAIRIE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1795
Mailing Address - Country:US
Mailing Address - Phone:972-316-4555
Mailing Address - Fax:972-316-4550
Practice Address - Street 1:2440 E PROSPER TRL STE 70
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9280
Practice Address - Country:US
Practice Address - Phone:972-316-4555
Practice Address - Fax:972-316-4550
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04782363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant