MEDICARE: JEFFREY W HENKE 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	208600000X	Surgery Physician	81256	AZ
2	208600000X	Surgery Physician	P2670	TX

General Provider Information

NPI Number	:	1811194384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY W HENKE M.D.

Provider Business Mailing Address
First Line	:	12201 MERIT DR STE 440
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75251-3106
Country	:	US
Telephone Number	:	214-823-5000
Fax Number	:	214-824-7167

Provider Business Practice Location Address
First Line	:	12201 MERIT DR STE 440
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75251-3106
Country	:	US
Telephone Number	:	214-823-5000
Fax Number	:	214-824-7167

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

Provider Enumeration Date	:	06/28/2007
Last Update Date	:	11/21/2022

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Directions to “ JEFFREY W HENKE M.D.” Practice Location

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