Provider Demographics
NPI:1730398157
Name:PIEFER, JASON WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:WILLIAM
Last Name:PIEFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1441 WOODSTEAD CT
Mailing Address - Street 2:STE 300
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1410
Mailing Address - Country:US
Mailing Address - Phone:281-367-0400
Mailing Address - Fax:281-367-1201
Practice Address - Street 1:1441 WOODSTEAD CT
Practice Address - Street 2:STE 300
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1410
Practice Address - Country:US
Practice Address - Phone:281-367-0400
Practice Address - Fax:281-367-1201
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN8969207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX760257221OtherTAX ID
TXTXB132647Medicare PIN