Provider Demographics
NPI:1538250683
Name:CASH, JACK QUINTEN (MD)
Entity type:Individual
Prefix:
First Name:JACK
Middle Name:QUINTEN
Last Name:CASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 N ALLEY ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75657-1408
Mailing Address - Country:US
Mailing Address - Phone:903-665-1014
Mailing Address - Fax:903-665-3315
Practice Address - Street 1:106 N ALLEY ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:TX
Practice Address - Zip Code:75657-1408
Practice Address - Country:US
Practice Address - Phone:903-665-1014
Practice Address - Fax:903-665-3315
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7935207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine