Provider Demographics
NPI:1457441073
Name:SCHWARTZ, JASON JOEL (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:JOEL
Last Name:SCHWARTZ
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 1:5939 HARRY HINES BOULEVARD
Mailing Address - Street 2:HQ8.827
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-8567
Mailing Address - Country:US
Mailing Address - Phone:214-645-7881
Mailing Address - Fax:214-645-6771
Practice Address - Street 1:5939 HARRY HINES BOULEVARD
Practice Address - Street 2:HQ7.700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9258
Practice Address - Country:US
Practice Address - Phone:214-645-1919
Practice Address - Fax:214-645-1918
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5950069-1205208600000X
TXK9410204F00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D6382Medicare UPIN
005806620Medicare PIN