| Doctor Name: | JERROD ALAN TABER |
| NPI Number: | 1407184476 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | |
| Business Practice Address: | 700 N Hwy 281 Marble Falls, TX - 786545106 |
| Business Phone Number: | 8306932600 |
| Business Fax Number: | 8306939755 |
| Mailing Address: | Po Box 1219, BURNET |
| State: | TX |
| Postal Code: | 786117219 |
| Phone Number: | 8306932600 |
| Fax Number: | 8306939755 |
| NPI Enumeration Date: | 12/02/2009 |
| NPI Last Update Date: | 12/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |