Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jesse Supernaw

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1619617065

Jesse Supernaw is a Student in an Organized Health Care Education/Training Program in Temple, Texas. Licensed in Texas. Registered with an NPI since 2022.

Licensed in
TX
In the registry since
2022
Specialties on file
2

Practice location Address checks out

2401 S 31st St
Temple, TX 76508-0001
Phone: (254) 724-5306
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence W7465 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1619617065
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 31, 2022
Last updated in NPPESJune 29, 2026
Certification dateJune 29, 2026
Mailing address2401 S 31st St, Temple, TX 76508-0001

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