Individual provider · Type 1 NPI

Jacob Daniel Ethridge, PA

Physician Assistant · San Antonio, TX

NPI number 1104301852 Active

Practice location

1150 N Loop 1604 W Ste 150
San Antonio, TX 78248-4505

Call (281) 783-8162 Map

Fax (713) 439-7995

Mailing address

2925 Briarpark Dr Ste 575
Houston, TX 77042-3776

Other practice locations

  • 10423 State Highway 151 Ste 101, San Antonio, TX 78251-4768 · (210) 341-9614
  • 5282 Medical Dr Ste 250, San Antonio, TX 78229-6039 · (210) 341-9614

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XTEMPORARY (TX)
Physician Assistant Primary 363A00000XPA12348 (TX)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1104301852

Jacob Daniel Ethridge, PA's National Provider Identifier is 1104301852, issued on Sep 28, 2018. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in San Antonio, TX. The record was last updated on Jun 29, 2022.