Individual
DOUGLAS DUART JEFFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2201 S CLEAR CREEK RD, KILLEEN, TX 76549-4110
(254) 526-7523
Mailing address
2212 TEAKWOOD CT, LEWISVILLE, TX 75067-6533
(214) 557-0736
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M7307
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188106201
—
TX
05
—
188106202
—
TX
05
—
188106203
—
TX
05
—
188106204
—
TX
05
—
188106205
—
TX
01
—
8AB482
BCBS
TX
01
—
8AB508
BCBS
TX
01
—
8AE922
BCBS
TX
01
—
8AE932
BCBS
TX
01
—
8AS826
BCBS
TX
01
—
8X9292
BCBS
TX
Enumeration date
05/24/2007
Last updated
03/05/2008
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