Provider Demographics
NPI:1447455860
Name:VORACHARD, JARED AMNARD (MD)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:AMNARD
Last Name:VORACHARD
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 1:6301 ALMEDA RD APT 645
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-1086
Mailing Address - Country:US
Mailing Address - Phone:713-842-1397
Mailing Address - Fax:
Practice Address - Street 1:3201 S WATER ST
Practice Address - Street 2:
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-4510
Practice Address - Country:US
Practice Address - Phone:512-756-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-16
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6939207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188123701Medicaid
TX188123703Medicaid
TX8X7479OtherBCBS
TX8X7677OtherBCBS
TX188123702Medicaid
TX8AV201OtherBCBS
TX8S6628OtherBCBS
TX8AV201OtherBCBS
TX188123703Medicaid
TX8J9274Medicare PIN