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NPI Code Detail

MEDICARE: DR. DEREK JAMES LEJEUNE M.D.

MEDICARE: DR. DEREK JAMES LEJEUNE 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
1207R00000XInternal Medicine PhysicianMD.200268LA
2207R00000XInternal Medicine PhysicianM4280TX
3207RH0002XHospice and Palliative Medicine (Internal Medicine) PhysicianM4280TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1884655OTHERTXMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609895002
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEREK JAMES LEJEUNE M.D.
Provider Business Mailing Address
First Line : 251 WESTPARK WAY STE 210
Second Line :
City : EULESS
State : TX
Zip : 76040-3742
Country : US
Telephone Number : 682-236-3656
Fax Number : 855-813-9308
Provider Business Practice Location Address
First Line : 4107 SPICEWOOD SPRINGS RD STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78759-8645
Country : US
Telephone Number : 512-397-3360
Fax Number : 512-343-7107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 01/19/2023

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