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NPI Code Detail

MEDICARE: JEREMY DUNFORD

MEDICARE:   JEREMY  DUNFORD
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
1235Z00000XSpeech-Language Pathologist106934TX

General Provider Information

NPI Number : 1235490111
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY DUNFORD
Provider Business Mailing Address
First Line : PO BOX 251236
Second Line :
City : PLANO
State : TX
Zip : 75025-1236
Country : US
Telephone Number : 972-584-0284
Fax Number :
Provider Business Practice Location Address
First Line : 4409 HELSTON DR
Second Line :
City : PLANO
State : TX
Zip : 75024-3748
Country : US
Telephone Number : 972-584-0284
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2012
Last Update Date : 06/06/2012

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Directions to “ JEREMY DUNFORD ” Practice Location

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