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General NPI Number Information
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NPI Number | 1144493156
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Entity Type | Organization
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Legal Business Name | JASON MARCHETTI MD PA
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/02/2024
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Provider Practice Location Address
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Address Line | 4333 N JOSEY LN STE 204
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City | CARROLLTON
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State | TX
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Zip | 75010-4631
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Country | US
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Telephone | 214-233-6490
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Fax | 888-417-4939
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Provider Business Mailing Address
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Address Line | 815 LADY OF THE LAKE BLVD
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City | LEWISVILLE
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State | TX
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Zip | 75056-5720
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Country | US
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Telephone | 214-402-4825
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Fax | 888-417-4939
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASON M MARCHETTI
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Credential | M.D.
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Telephone | 214-402-4825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | L7470
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License Number State | TX
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