Provider Demographics
NPI:1467722967
Name:JENSEN, JAY B (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:B
Last Name:JENSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1117 COTTONWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-6662
Mailing Address - Country:US
Mailing Address - Phone:817-645-0525
Mailing Address - Fax:817-645-0525
Practice Address - Street 1:1117 COTTONWOOD CT
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-6662
Practice Address - Country:US
Practice Address - Phone:817-645-0525
Practice Address - Fax:817-645-0525
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-31
Last Update Date:2011-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7841207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease