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NPI Code Detail

MEDICARE: JAY C STORY MD

MEDICARE: JAY C STORY 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
1207Q00000XFamily Medicine PhysicianG7595TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801878178
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAY C STORY MD
Provider Business Mailing Address
First Line : 141 COTTONWOOD DR
Second Line :
City : COPPELL
State : TX
Zip : 75019-2512
Country : US
Telephone Number : 972-393-1432
Fax Number :
Provider Business Practice Location Address
First Line : 580 S DENTON TAP RD
Second Line : #123
City : COPPELL
State : TX
Zip : 75019-4098
Country : US
Telephone Number : 972-462-0762
Fax Number : 972-393-2133
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2005
Last Update Date : 08/14/2009

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Directions to “ JAY C STORY MD” Practice Location

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