MEDICARE: DR. JESSICA NICOLE DUNN 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	207R00000X	Internal Medicine Physician	R0152	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	544331YLLW	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8GH189	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992143804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA NICOLE DUNN M.D.

Provider Business Mailing Address
First Line	:	4410 MEDICAL DR STE 100
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3737
Country	:	US
Telephone Number	:	210-614-4000
Fax Number	:	210-616-0449

Provider Business Practice Location Address
First Line	:	4410 MEDICAL DR STE 100
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3737
Country	:	US
Telephone Number	:	210-614-4000
Fax Number	:	210-616-0449

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

Provider Enumeration Date	:	06/13/2013
Last Update Date	:	01/23/2025

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