MEDICARE: PORCHIA JEFFERSON

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	106S00000X	Behavior Technician		TX

General Provider Information

NPI Number	:	1063357135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PORCHIA JEFFERSON

Provider Business Mailing Address
First Line	:	3612 HOLLYWOOD AVE
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39213-6325
Country	:	US
Telephone Number	:	888-754-0398
Fax Number	:

Provider Business Practice Location Address
First Line	:	16060 DALLAS PKWY APT 119
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-1002
Country	:	US
Telephone Number	:	888-754-0398
Fax Number	:

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

Provider Enumeration Date	:	04/23/2026
Last Update Date	:	04/23/2026

Similar Medicare Providers

1790737823 — ANNE MASSON LCSW
Practice Location Address:

17820 WINDFLOWER WAY UNIT 1002
DALLAS, TX
75252-5210

Practice Phone: 972-571-2450
Practice Fax:

1609892827 — DR. JEFFREY SCOTT MCKINNEY MD PHD
Practice Location Address:

5323 HARRY HINES BLVD
DALLAS, TX
75390-1002

Practice Phone: 214-456-5518
Practice Fax: 214-456-2625

1023148723 — GOLDEN RULE SCHOOLS INC
Practice Location Address:

2602 W ILLINOIS AVE
DALLAS, TX
75233-1002

Practice Phone: 214-333-9330
Practice Fax: 214-333-9325

1235252982 — MRS. MEGHAN PATRICIA GUSTAFSON RN, CPNP
Practice Location Address:

5323 HARRY HINES BLVD STOP 7200
DALLAS, TX
75390-1002

Practice Phone: 214-648-3111
Practice Fax:

1891976486 — DR. SIRINE A BALTAGI MD
Practice Location Address:

5323 HARRY HINES BLVD
DALLAS, TX
75390-1002

Practice Phone: 214-730-5437
Practice Fax:

1114151008 — TIPPLE ALLIANCE HOME HEALTH SERVICES, INC.
Practice Location Address:

10729 AUDELIA RD , SUITE # 210
DALLAS, TX
75238-1002

Practice Phone: 214-221-7734
Practice Fax: 214-221-6755

Directions to “ PORCHIA JEFFERSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.