Organization
MRJ MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ROBERT JAFFE M.D. (PHYSICIAN)
(214) 276-0039
Entity
Organization
Contact information
Practice address
5744 LBJ FWY, SUITE 180, DALLAS, TX 75240-6322
(214) 276-0039
(469) 484-4076
Mailing address
5744 LBJ FWY, SUITE180, DALLAS, TX 75240-6322
(214) 276-0039
(469) 484-4076
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164971701
—
TX
Enumeration date
03/20/2008
Last updated
12/28/2015
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