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NPI Code Detail

MEDICARE: JEROME MARC KANE M.D.

MEDICARE: JEROME MARC KANE 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
12084N0400XNeurology PhysicianG6538TX

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 : 1558364232
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEROME MARC KANE M.D.
Provider Business Mailing Address
First Line : 3030 HARWOOD RD STE 100
Second Line :
City : BEDFORD
State : TX
Zip : 76021-3703
Country : US
Telephone Number : 817-267-6290
Fax Number : 817-267-0950
Provider Business Practice Location Address
First Line : 3030 HARWOOD RD STE 100
Second Line :
City : BEDFORD
State : TX
Zip : 76021-3703
Country : US
Telephone Number : 817-267-6290
Fax Number : 817-267-0950
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 12/05/2025

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