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NPI Code Detail

MEDICARE: JAMIE M WALDREP MD PA

MEDICARE: JAMIE M WALDREP MD PA
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
1208000000XPediatrics PhysicianM3107TX
2208000000XPediatrics Physician

Other Identifiers

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

General Provider Information

NPI Number : 1548228893
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAMIE M WALDREP MD PA
Provider Business Mailing Address
First Line : 250 STRICKLAND DR
Second Line :
City : ORANGE
State : TX
Zip : 77630-4750
Country : US
Telephone Number : 409-883-7900
Fax Number : 409-883-7909
Provider Business Practice Location Address
First Line : 250 STRICKLAND DR
Second Line :
City : ORANGE
State : TX
Zip : 77630-4750
Country : US
Telephone Number : 409-883-7900
Fax Number : 409-883-7909
Authorized Official
Title or Position : OWNER
Name : DR. JAMIE M WALDREP
Credential : MD
Telephone Number : 409-883-7900
Provider Enumeration Date : 05/03/2006
Last Update Date : 08/01/2022

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Directions to “JAMIE M WALDREP MD PA ” Practice Location

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