Provider Demographics
NPI:1700818390
Name:TOUBIN, JEFFREY CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CHARLES
Last Name:TOUBIN
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:
Practice Address - Street 1:1411 N BECKLEY AVE
Practice Address - Street 2:SUITE 464
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1259
Practice Address - Country:US
Practice Address - Phone:214-948-3101
Practice Address - Fax:214-941-7633
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7387208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001894350OtherUNITED HEALTH
TX030284602Medicaid
TX340016656OtherRAIL ROAD MEDICARE
TX2219925OtherAETNA
TX9832308003OtherCIGNA
TX030284601Medicaid
TXP01322831OtherRAILROAD MEDICARE
TX030284603Medicaid
TX8A9485OtherBLUECROSS BLUESHIELD
TXP01322831OtherRAILROAD MEDICARE
TX030284601Medicaid
TX344783YM09Medicare PIN
TXG94394Medicare UPIN