Provider Demographics
NPI:1104810225
Name:ALBRACHT, JAMISON MATTHEW (DO)
Entity type:Individual
Prefix:
First Name:JAMISON
Middle Name:MATTHEW
Last Name:ALBRACHT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9990 DALLAS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4133
Mailing Address - Country:US
Mailing Address - Phone:214-387-8288
Mailing Address - Fax:214-387-8289
Practice Address - Street 1:9990 DALLAS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4133
Practice Address - Country:US
Practice Address - Phone:214-387-8288
Practice Address - Fax:214-387-8289
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2021-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK5766207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG77584Medicare UPIN