MEDICARE: JASON M LAFON PA

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	363AS0400X	Surgical Physician Assistant	PA02910	TX
2	363A00000X	Physician Assistant	PA02910	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	816N46	OTHER	TX	BCBSTX

General Provider Information

NPI Number	:	1144390634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON M LAFON PA

Provider Business Mailing Address
First Line	:	8210 WALNUT HILL LN STE 130
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4418
Country	:	US
Telephone Number	:	214-750-1207
Fax Number	:

Provider Business Practice Location Address
First Line	:	8210 WALNUT HILL LN
Second Line	:	STE 130 LB 11
City	:	DALLAS
State	:	TX
Zip	:	75231-4405
Country	:	US
Telephone Number	:	214-750-1207
Fax Number	:

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

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	05/05/2026

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Directions to “ JASON M LAFON PA” Practice Location

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