Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | M0951 | TX |
NPI | 1003878562 |
---|---|
Provider Name | Dr. Jeffrey Jasper Tramonte |
First Address | Dallas, TX 75284-4658 |
Second Address | Round Rock, TX 78665 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 30/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1741597-01 | (05) | TX |
1741597-02 | CSHCN (01) | TX |
8S0391 | BLUE SHIELD (01) | TX |
I29070 | (02) | TX |
P00234963 | RR/MEDICARE (01) | TX |