MEDICARE: DR. JEFFREY LIDDELL 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	207QA0505X	Adult Medicine Physician	J7809	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376583955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY LIDDELL M.D.

Provider Business Mailing Address
First Line	:	4131 N CENTRAL EXPY
Second Line	:	SUITE 440 - FITZHUGH-CENTRAL PROFESSIONAL TOWER
City	:	DALLAS
State	:	TX
Zip	:	75204-2102
Country	:	US
Telephone Number	:	214-521-3091
Fax Number	:	214-521-2182

Provider Business Practice Location Address
First Line	:	4131 N CENTRAL EXPY
Second Line	:	SUITE 440 - FITZHUGH-CENTRAL PROFESSIONAL TOWER
City	:	DALLAS
State	:	TX
Zip	:	75204-2102
Country	:	US
Telephone Number	:	214-521-3091
Fax Number	:	214-521-2182

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	11/23/2010

Similar Medicare Providers

1124842620 — LONESTAR MENTAL HEALTH LLC
Practice Location Address:

4131 N CENTRAL EXPY STE 900 OFFICE 359
DALLAS, TX
75204-2102

Practice Phone: 737-888-5592
Practice Fax:

1174527964 — BENJAMIN KIM M.D.
Practice Location Address:

4131 N CENTRAL EXPY , STE 435
DALLAS, TX
75204-2102

Practice Phone: 214-826-6500
Practice Fax:

1336144724 — MICHAEL ALLISON M.D.
Practice Location Address:

4131 N CENTRAL EXPY , STE 435
DALLAS, TX
75204-2102

Practice Phone: 214-252-3501
Practice Fax:

1386649218 — AL MOORE M.D.
Practice Location Address:

4131 N CENTRAL EXPY , STE 435
DALLAS, TX
75204-2102

Practice Phone: 214-252-3501
Practice Fax:

1669425112 — METROPOLITAN ANESTHESIA CONSULTANTS, PA
Practice Location Address:

4131 N CENTRAL EXPY , SUITE 435
DALLAS, TX
75204-2102

Practice Phone: 214-252-3501
Practice Fax:

1255378691 — MICHAEL SHANE KOHANSKI M.D.
Practice Location Address:

4131 N CENTRAL EXPY , SUITE 435
DALLAS, TX
75204-2102

Practice Phone: 214-252-3501
Practice Fax:

Directions to “ DR. JEFFREY LIDDELL M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.