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NPI Code Detail

MEDICARE: JUNE MARIE JEFFERSON-RANDOLPH

MEDICARE: JUNE MARIE JEFFERSON-RANDOLPH
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
1251B00000XCase Management Agency
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1245197177
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUNE MARIE JEFFERSON-RANDOLPH
Provider Business Mailing Address
First Line : 1111 W MOCKINGBIRD LN STE 480
Second Line :
City : DALLAS
State : TX
Zip : 75247-5062
Country : US
Telephone Number : 972-489-5552
Fax Number :
Provider Business Practice Location Address
First Line : 1111 W MOCKINGBIRD LN STE 480
Second Line :
City : DALLAS
State : TX
Zip : 75247-5062
Country : US
Telephone Number : 972-489-5552
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ JUNE MARIE JEFFERSON-RANDOLPH ” Practice Location

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