Healthcare Provider Details

I. General information

NPI: 1417991126
Provider Name (Legal Business Name): JASON R BUTTLES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 PRESTON RD
PLANO TX
75024-3214
US

IV. Provider business mailing address

1935 MEDICAL DISTRICT DR
DALLAS TX
75235-7701
US

V. Phone/Fax

Practice location:
  • Phone: 469-303-7000
  • Fax:
Mailing address:
  • Phone: 214-456-9250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM7076
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: