Provider Demographics
NPI:1568456879
Name:CEJA, JOSE FRANCISCO (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:FRANCISCO
Last Name:CEJA
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 1:2660 SCRIPTURE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-4339
Mailing Address - Country:US
Mailing Address - Phone:940-484-8400
Mailing Address - Fax:940-484-8409
Practice Address - Street 1:2660 SCRIPTURE ST STE 100
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4339
Practice Address - Country:US
Practice Address - Phone:940-484-8400
Practice Address - Fax:940-484-8409
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2020-03-02
Deactivation Date:2006-03-24
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
TXK3696207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00687WOtherMEDICARE GROUP NUMBER
TX4670934OtherAETNA
TX0018LBOtherBLUE CROSS BLUE SHIELD
TX1732844Medicaid
8B8475Medicare ID - Type Unspecified
TX4670934OtherAETNA