Jake Everett Backen, RVT
Radiologic Technologist, Vascular Sonography in San Antonio, TX. Individual provider (NPI-1).
NPI number1356932024
StatusActive
Last updated in NPPESJan 26, 2021
Details
- NPI
- 1356932024
- Entity type
- Individual (NPI-1)
- Name
- Jake Everett Backen
- Credential
- RVT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 26, 2021
- Certification date
- Jan 26, 2021
- Last updated
- Jan 26, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2471V0105X | Radiologic Technologist, Vascular Sonography | 193402 | OR | Yes |
Practice location
415 W Lynwood Ave Apt 2San Antonio, TX 78212-2239
Phone 541-680-2858
Mailing address
415 W Lynwood Ave Apt 2San Antonio, TX 78212-2239
Phone 541-680-2858
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