Organization
T. JEFF RUSSELL, M.D., P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY KITCHER (CREDENTIALING)
(214) 522-2661
Entity
Organization
Contact information
Practice address
2801 LEMMON AVE WEST, SUITE 310, DALLAS, TX 75204
(214) 522-2661
(214) 522-5469
Mailing address
2801 LEMMON AVE WEST, SUITE 310, DALLAS, TX 75204
(214) 522-2661
(214) 522-5469
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144819301
—
TX
01
—
180041912
RAILROAD MEDICARE
TX
Enumeration date
04/04/2007
Last updated
06/03/2008
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