Provider Demographics
NPI:1023249992
Name:JEB S. MIERS M.D., P.A
Entity type:Organization
Organization Name:JEB S. MIERS M.D., P.A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEB
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:MIERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-696-1118
Mailing Address - Street 1:8210 WALNUT HILL LANE
Mailing Address - Street 2:812
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:214-696-1118
Mailing Address - Fax:214-696-4447
Practice Address - Street 1:8210 WALNUT HILL LANE
Practice Address - Street 2:812
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:214-696-1118
Practice Address - Fax:214-696-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8725207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty