Provider Demographics
NPI:1588612451
Name:SCHUSSLER, JEFFREY M (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:SCHUSSLER
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 1:621 N HALL ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226-1339
Mailing Address - Country:US
Mailing Address - Phone:469-800-7400
Mailing Address - Fax:469-800-7440
Practice Address - Street 1:621 N HALL ST
Practice Address - Street 2:SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1339
Practice Address - Country:US
Practice Address - Phone:469-800-7400
Practice Address - Fax:469-800-7440
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0375207RI0011X, 207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1498123-02Medicaid
TX1498123-03Medicaid
TX149812301Medicaid
TX045713702Medicaid
TX1498123-02Medicaid
TX345791YKTPMedicare PIN
TXG53019Medicare UPIN
TX045713702Medicaid