MEDICARE: DR. MICHAEL DAVID JAMESON 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	207RN0300X	Nephrology Physician	HO492	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	390001182	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89K852	OTHER	TX	BLUE CROSS BLUE SHIELD
2	007	OTHER		TRICARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306895347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DAVID JAMESON M.D

Provider Business Mailing Address
First Line	:	8600 MEADOWBROOK DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76120-4612
Country	:	US
Telephone Number	:	817-265-9700
Fax Number	:	817-277-4164

Provider Business Practice Location Address
First Line	:	1132 S BOWEN RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-2204
Country	:	US
Telephone Number	:	817-265-9700
Fax Number	:	817-277-4164

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	08/25/2022

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