Individual ProviderJared W BushPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address4700 Seton Center Pkwy, Ste 200, Austin, TX 78759-5295(512) 439-1000PECOS EnrollmentBased on the most recent information from CMS, provider Jared W Bush does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1396751418Provider TypeIndividualFull NameBush, Jared WTitleMr.CredentialP.A.GenderMaleSole ProprietorNoEnumeration Date7/31/2006Last Updated11/20/2019Contact InformationPractice LocationPractice Address4700 Seton Center Pkwy, Ste 200, Austin, TX 78759-5295Phone(512) 439-1000Fax(512) 439-1081Mailing LocationMailing Address4700 Seton Center Pkwy, Ste 200, Austin, TX 78759-5295Phone(512) 439-1000Fax(512) 439-1081Provider TaxonomiesCodeDescriptionLicenseCode363AS0400XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA05744TexasCode363A00000XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense1878ColoradoProvider IdentifiersIDDescriptionIssuerIDP00690919DescriptionOtherIssuerRAILROAD MEDICARETexas