MEDICARE: DR. DHIRESH ROHAN JEYARAJAH M.D.

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	208600000X	Surgery Physician	K3263	TX

General Provider Information

NPI Number	:	1235186446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DHIRESH ROHAN JEYARAJAH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 674096
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75267-4096
Country	:	US
Telephone Number	:	972-616-4000
Fax Number	:	972-294-3343

Provider Business Practice Location Address
First Line	:	2805 E PRESIDENT GEORGE BUSH HWY
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-3561
Country	:	US
Telephone Number	:	972-619-3500
Fax Number	:	214-272-8985

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	10/02/2023

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