Provider Demographics
NPI:1215995550
Name:BIGGERS, JEFFREY BLAIR (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:BLAIR
Last Name:BIGGERS
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 1:1050 N BELT LINE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-1782
Mailing Address - Country:US
Mailing Address - Phone:972-285-8981
Mailing Address - Fax:972-216-5845
Practice Address - Street 1:1050 N BELT LINE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1782
Practice Address - Country:US
Practice Address - Phone:972-285-8981
Practice Address - Fax:972-216-5845
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9203208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
00QU99OtherBCBS
TX035523201Medicaid
4548502OtherCIGNA
4391495OtherAETNA
4548502OtherCIGNA
TX00QU99Medicare ID - Type Unspecified