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

Kenneth M Jastrow III, MD

Individual provider Surgery Physician · NPI 1740556448

Kenneth M Jastrow III, MD is a General Surgery in San Angelo, Texas. Qualified in 2012, 14 years ago. Practices with Shannon Clinic, a 547-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
14
Licensed in
TX
In the registry since
2012
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

102 N Magdalen St
San Angelo, TX 76903-5400
Phone: (325) 658-1511
Fax: (325) 481-2165
Show map & directions

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

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence P4968 (TX)

Record details

NPI number1740556448
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 27, 2012
Last updated in NPPESApril 23, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Shannon Clinic — 547 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

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