MEDICARE: JESSICA NICHOLE THAYER 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	207WX0110X	Pediatric Ophthalmology and Strabismus Specialist Physician Physician	T0016	TX
2	207W00000X	Ophthalmology Physician	T0016	TX

General Provider Information

NPI Number	:	1720440845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA NICHOLE THAYER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 845347 DEPARTMENT OF OPHTHALMOLOGY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-5347
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7609 PRESTON RD # P-2200
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-3415
Country	:	US
Telephone Number	:	469-497-2503
Fax Number	:

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

Provider Enumeration Date	:	03/28/2016
Last Update Date	:	02/16/2026

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