Provider Demographics
NPI:1497952808
Name:WOLF, JASON LINDSEY (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:LINDSEY
Last Name:WOLF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1820 PRESTON PARK BLVD
Mailing Address - Street 2:STE 2400
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3716
Mailing Address - Country:US
Mailing Address - Phone:972-867-7862
Mailing Address - Fax:
Practice Address - Street 1:2950 OLD SPANISH TRL
Practice Address - Street 2:APT 122
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2227
Practice Address - Country:US
Practice Address - Phone:254-624-5597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2021-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO20080250562085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology