Organization
HENRY C JEFFERSON MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY CHARLES JEFFERSON M.D. (PHYSICIAN)
(214) 942-3295
Entity
Organization
Contact information
Practice address
221 W COLORADO BLVD, PAV II STE 829, DALLAS, TX 75208-2363
(214) 942-3295
(214) 946-4491
Mailing address
221 W COLORADO BLVD, PAV II STE 829, DALLAS, TX 75208-2363
(214) 942-3295
(214) 946-4491
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
J0020
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207721601
—
TX
Enumeration date
04/16/2009
Last updated
03/19/2010
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