Individual
DR. JACK JAFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
6330 LYNDON B JOHNSON FWY STE 130, DALLAS, TX 75240-6443
(972) 693-5485
Mailing address
7422 FOXWORTH DR, DALLAS, TX 75248-3038
(972) 693-5485
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
31536
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149708301
—
TX
01
—
86707A
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/18/2006
Last updated
11/21/2022
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