Provider Demographics
NPI:1477788065
Name:SAMEER S. JEJURIKAR, M.D., P.A.
Entity Type:Organization
Organization Name:SAMEER S. JEJURIKAR, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:HOBAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-823-8423
Mailing Address - Street 1:9101 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5927
Mailing Address - Country:US
Mailing Address - Phone:214-823-5023
Mailing Address - Fax:214-887-1897
Practice Address - Street 1:9101 N CENTRAL EXPY
Practice Address - Street 2:SUITE 600
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5927
Practice Address - Country:US
Practice Address - Phone:214-823-5023
Practice Address - Fax:214-887-1897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3592208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A4563Medicare PIN
TX0A4011Medicare PIN