MEDICARE: JOHN M GEORGE 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	207RI0011X	Interventional Cardiology Physician	P7636	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	381364YKQJ	OTHER	TX	MEDICARE
2	381364YK5B	OTHER	TX	MEDICARE

General Provider Information

NPI Number	:	1891798856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN M GEORGE M.D.

Provider Business Mailing Address
First Line	:	2821 E PRESIDENT GEORGE BUSH HWY STE 404
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-4278
Country	:	US
Telephone Number	:	214-943-1191
Fax Number	:	214-599-2601

Provider Business Practice Location Address
First Line	:	2821 E PRESIDENT GEORGE BUSH HWY
Second Line	:	SUITE 505
City	:	RICHARDSON
State	:	TX
Zip	:	75082-4266
Country	:	US
Telephone Number	:	214-943-1191
Fax Number	:	214-599-2601

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	03/21/2018

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Directions to “ JOHN M GEORGE M.D.” Practice Location

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