MEDICARE: JASON P GEORGE 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
1	207R00000X	Internal Medicine Physician	N1327	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8BU165	OTHER		BLUE CROSS BLUE SHIELD OF TEXAS

General Provider Information

NPI Number	:	1720237365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON P GEORGE MD

Provider Business Mailing Address
First Line	:	2704 N GALLOWAY AVE
Second Line	:	SUITE 103
City	:	MESQUITE
State	:	TX
Zip	:	75150-6378
Country	:	US
Telephone Number	:	214-660-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	2704 N GALLOWAY AVE
Second Line	:	SUITE 103
City	:	MESQUITE
State	:	TX
Zip	:	75150-6378
Country	:	US
Telephone Number	:	214-660-2500
Fax Number	:

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

Provider Enumeration Date	:	09/18/2008
Last Update Date	:	10/15/2010

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Directions to “ JASON P GEORGE MD” Practice Location

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