Provider Demographics
NPI:1992859672
Name:MING, JEFFREY A (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:MING
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:17304 PRESTON RD
Mailing Address - Street 2:SUITE 555
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5618
Mailing Address - Country:US
Mailing Address - Phone:866-931-8882
Mailing Address - Fax:972-934-3174
Practice Address - Street 1:17304 PRESTON RD
Practice Address - Street 2:SUITE 555
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5618
Practice Address - Country:US
Practice Address - Phone:866-931-8882
Practice Address - Fax:972-934-3174
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS12604207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSE65050Medicare UPIN