Provider Demographics
NPI:1639114101
Name:JEJURIKAR, SAMEER SUBHASH (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMEER
Middle Name:SUBHASH
Last Name:JEJURIKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9101 NORTH CENTRAL EXPRESSWAY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:214-827-2814
Mailing Address - Fax:469-375-3821
Practice Address - Street 1:9101 NORTH CENTRAL EXPRESSWAY
Practice Address - Street 2:SUITE 600
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:214-827-2814
Practice Address - Fax:469-375-3821
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM3592208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F21732Medicare PIN
TX8F21611Medicare PIN