MEDICARE: JONATHAN NATHAN MD MBA PLLC

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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1467386185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONATHAN NATHAN MD MBA PLLC

Provider Business Mailing Address
First Line	:	3900 JUNIUS ST STE 605
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-1630
Country	:	US
Telephone Number	:	214-814-1711
Fax Number	:	214-292-8709

Provider Business Practice Location Address
First Line	:	3900 JUNIUS ST STE 605
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-1630
Country	:	US
Telephone Number	:	214-814-1711
Fax Number	:	214-292-8709

Authorized Official
Title or Position	:	OWNER
Name	:	JONATHAN NATHAN
Credential	:	MD
Telephone Number	:	214-814-1711

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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