Individual
DR. JERRY DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 CHISHOLM PL STE 406, PLANO, TX 75075-6911
(972) 588-4541
(469) 304-0139
Mailing address
PO BOX 251606, PLANO, TX 75025-1510
(972) 588-4541
(469) 304-0139
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
9167
FL
207L00000X
Anesthesiology Physician
ME103913
FL
207L00000X
Anesthesiology Physician
Primary
N3000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206024601
—
TX
01
—
8CD178
BLUE CROSS BLUE SHIELD
TX
01
—
P00826720
RAILROAD MEDICARE
TX
Enumeration date
09/03/2008
Last updated
09/20/2022
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