MEDICARE: DR. JASON DARREN ROBINSON 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	M0887	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

General Provider Information

NPI Number	:	1962485805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON DARREN ROBINSON MD

Provider Business Mailing Address
First Line	:	1913 WIND LAKE CIR
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75040-1170
Country	:	US
Telephone Number	:	214-454-6641
Fax Number	:	972-272-1240

Provider Business Practice Location Address
First Line	:	1913 WIND LAKE CIR
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75040-1170
Country	:	US
Telephone Number	:	214-454-6641
Fax Number	:	972-272-1240

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

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	04/20/2011

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