Organization
G. KIMBLE JETT, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY KIMBLE JETT MD (PRESIDENT, SURGEON)
(972) 731-7506
Entity
Organization
Contact information
Practice address
5575 WARREN PKWY STE 306, FRISCO, TX 75034-4097
(972) 731-7506
(972) 731-7512
Mailing address
5575 WARREN PKWY STE 306, FRISCO, TX 75034-4097
(972) 731-7506
(972) 731-7512
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
F1681
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00729W
MEDICARE
TX
05
—
0979981
—
TX
Enumeration date
10/18/2007
Last updated
12/20/2011
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