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Individual
DR. DAVID L JANSSEN
Active
Individual
DR. DAVID L JANSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
G3494
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125696801
—
TX
05
—
125696802
—
TX
01
—
742569553
EMPLOYER ID - ROAST
TX
01
—
760387962
EMPLOYER ID - ROAGC
TX
01
—
85R632
BLUE CROSS/SHIELD - ROAST
TX
01
—
88R662
BLUE CROSS/SHIELD - ROAGC
TX
01
—
920000190
RAIL ROAD MEDICARE
TX
Enumeration date
11/02/2006
Last updated
02/02/2010
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