MEDICARE: JAYE ALEXANDER WESTON

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	A155261	CA
2	390200000X	Student in an Organized Health Care Education/Training Program		CA
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	U5262	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	39	OTHER	CA	STUDENT HEALTH CARE

General Provider Information

NPI Number	:	1255795233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYE ALEXANDER WESTON

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-5347
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6201 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-5639
Country	:	US
Telephone Number	:	214-645-0355
Fax Number	:

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

Provider Enumeration Date	:	04/06/2016
Last Update Date	:	03/06/2024

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Directions to “ JAYE ALEXANDER WESTON ” Practice Location

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