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NPI Code Detail

MEDICARE: DR. JASON LINDSEY WOLF MD

MEDICARE:  DR. JASON LINDSEY WOLF  MD
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
12085R0202XDiagnostic Radiology Physician2008025056MO

General Provider Information

NPI Number : 1497952808
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON LINDSEY WOLF MD
Provider Business Mailing Address
First Line : 1820 PRESTON PARK BLVD
Second Line : STE 2400
City : PLANO
State : TX
Zip : 75093-3716
Country : US
Telephone Number : 972-867-7862
Fax Number :
Provider Business Practice Location Address
First Line : 2950 OLD SPANISH TRL
Second Line : APT 122
City : HOUSTON
State : TX
Zip : 77054-2227
Country : US
Telephone Number : 254-624-5597
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2007
Last Update Date : 12/22/2021

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Directions to “ DR. JASON LINDSEY WOLF MD” Practice Location

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