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NPI Code Detail

MEDICARE: JENNIFER DELIA HEFFERNAN MD

MEDICARE: JENNIFER DELIA HEFFERNAN 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 PhysicianM1751TX
2207QG0300XGeriatric Medicine (Family Medicine) PhysicianM1751TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00258017OTHERTXRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
38M6746OTHERTXBCBS

General Provider Information

NPI Number : 1992781256
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER DELIA HEFFERNAN MD
Provider Business Mailing Address
First Line : 4009 WORTH ST STE B
Second Line :
City : DALLAS
State : TX
Zip : 75246-1608
Country : US
Telephone Number : 214-820-9115
Fax Number : 214-820-9135
Provider Business Practice Location Address
First Line : 4009 WORTH ST STE B
Second Line :
City : DALLAS
State : TX
Zip : 75246-1608
Country : US
Telephone Number : 214-820-9115
Fax Number : 214-820-9135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 12/05/2025

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Directions to “ JENNIFER DELIA HEFFERNAN MD” Practice Location

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