Jay S. Roden
Pediatric Surgery
12200 Park Central Dr Ste 400
Dallas
, Texas 75251-2116
Jay S. Roden
Pediatric Surgery
12200 Park Central Dr Ste 400
Dallas
, Texas 75251-2116
(214) 483-9301
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Jay S. Roden
- 12200 Park Central Dr Ste 400
- Dallas, TX
- Zip : 75251-2116
- Fax : (214) 483-9301
- Phone : (214) 483-9300
Second Address
- Jay S. Roden
- 12200 Park Central Dr Ste 400
- Dallas, TX
- Zip : 75251-2116
- Fax : (214) 483-9301
- Phone : (214) 483-9300
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0120X | Pediatric Surgery | G0019 | TX |
National Provider Identifier
| NPI | 1093898447 |
|---|---|
| Provider Name | Jay S. Roden |
| First Address | Dallas, TX 75251-2116 |
| Second Address | Dallas, TX 75251-2116 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/10/2006 |
| Last Update Date | 11/05/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1330870-01 | (05) | TX |
| E12334 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.