MEDICARE: JEFFREY H LANDAU 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	208800000X	Urology Physician	77084	MN
2	208800000X	Urology Physician	G50587	CA
3	208800000X	Urology Physician	K4934	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8AJ901	OTHER	TX	BLUECROSS BLUE SHIELD

General Provider Information

NPI Number	:	1891788022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY H LANDAU M.D.

Provider Business Mailing Address
First Line	:	5100 W ELDORADO PKWY
Second Line	:	SUITE 102 PMB 901
City	:	MCKINNEY
State	:	TX
Zip	:	75070-6309
Country	:	US
Telephone Number	:	972-747-4200
Fax Number	:	972-747-4222

Provider Business Practice Location Address
First Line	:	1105 CENTRAL EXPY N
Second Line	:	SUITE 350
City	:	ALLEN
State	:	TX
Zip	:	75013-6103
Country	:	US
Telephone Number	:	972-747-4200
Fax Number	:

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	05/21/2024

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