MEDICARE: DR. JOSE T VALLEJOS MD

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	207R00000X	Internal Medicine Physician	Q5944	TX

General Provider Information

NPI Number	:	1427239409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE T VALLEJOS MD

Provider Business Mailing Address
First Line	:	9888 FERGUSON RD STE 101B
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-3841
Country	:	US
Telephone Number	:	214-328-4389
Fax Number	:	214-328-4085

Provider Business Practice Location Address
First Line	:	4325 N JOSEY LN STE 300
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4638
Country	:	US
Telephone Number	:	214-328-4389
Fax Number	:	214-328-4085

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

Provider Enumeration Date	:	11/19/2007
Last Update Date	:	03/11/2026

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