MEDICARE: JEROME G NAIFEH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	E1471	TX

General Provider Information

NPI Number	:	1003893728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEROME G NAIFEH M.D.

Provider Business Mailing Address
First Line	:	5637 CROWNDALE DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-8502
Country	:	US
Telephone Number	:	214-632-2606
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 MEDICAL PKWY STE 106
Second Line	:
City	:	FARMERS BRANCH
State	:	TX
Zip	:	75234-7838
Country	:	US
Telephone Number	:	214-632-2606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	10/11/2023

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