MEDICARE: DR. JEFFREY BURKETT SHROFF 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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	T5208	TX
2	207X00000X	Orthopaedic Surgery Physician	T5208	TX

General Provider Information

NPI Number	:	1518320977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY BURKETT SHROFF M.D.

Provider Business Mailing Address
First Line	:	6418 ECKHERT RD
Second Line	:	APT. 2301
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-2896
Country	:	US
Telephone Number	:	979-446-2877
Fax Number	:

Provider Business Practice Location Address
First Line	:	6418 ECKHERT RD
Second Line	:	APT. 2301
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-2896
Country	:	US
Telephone Number	:	979-446-2877
Fax Number	:

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

Provider Enumeration Date	:	04/03/2016
Last Update Date	:	02/01/2023

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