MEDICARE: MRS. DELANA BROOKE JONES 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	363AM0700X	Medical Physician Assistant	PA05416	TX

General Provider Information

NPI Number	:	1144417817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DELANA BROOKE JONES PA

Provider Business Mailing Address
First Line	:	125 W STATE HIGHWAY 121 STE 100
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-7987
Country	:	US
Telephone Number	:	214-203-0012
Fax Number	:	475-275-8032

Provider Business Practice Location Address
First Line	:	125 W STATE HIGHWAY 121 STE 100
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-7987
Country	:	US
Telephone Number	:	972-564-0352
Fax Number	:	972-552-7447

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

Provider Enumeration Date	:	09/26/2007
Last Update Date	:	02/03/2026

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