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Individual

JEREMEY D BAXTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AA

Contact information

Practice address
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240
(972) 715-1999
(972) 233-3666
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
337610502
TX
01
728
A A CERTICATE #
GA
Enumeration date
10/11/2006
Last updated
05/31/2018
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