MEDICARE: DR. JAY S GARTNER 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
1	207R00000X	Internal Medicine Physician	G6833	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

General Provider Information

NPI Number	:	1093775611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY S GARTNER MD

Provider Business Mailing Address
First Line	:	1918 OLIVE ST APT 2603
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-2289
Country	:	US
Telephone Number	:	214-696-4270
Fax Number	:	214-696-1419

Provider Business Practice Location Address
First Line	:	1918 OLIVE ST APT 2603
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-2289
Country	:	US
Telephone Number	:	214-696-4270
Fax Number	:	214-696-1419

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

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	01/06/2025

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Directions to “ DR. JAY S GARTNER MD” Practice Location

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