Provider Demographics
NPI:1356508733
Name:BELL, JAYSON P (MD)
Entity Type:Individual
Prefix:DR
First Name:JAYSON
Middle Name:P
Last Name:BELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7715 SAN JACINTO PL STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3215
Mailing Address - Country:US
Mailing Address - Phone:732-619-7008
Mailing Address - Fax:
Practice Address - Street 1:7715 SAN JACINTO PL STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3215
Practice Address - Country:US
Practice Address - Phone:732-619-7008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1088207X00000X
NJ25MA08462800207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
8HP202OtherMEDICARE GALLUP INDIAN MEDICAL CENTER PROVIDER NUMBER
AZ668202Medicaid
TX351363201Medicaid
NM49538861Medicaid