Provider Demographics
NPI:1245295989
Name:JARADAT, MAJD I (MD)
Entity type:Individual
Prefix:
First Name:MAJD
Middle Name:I
Last Name:JARADAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:901 W WALL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7414
Mailing Address - Country:US
Mailing Address - Phone:817-488-6669
Mailing Address - Fax:817-488-6671
Practice Address - Street 1:4907 S COLLINS ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1156
Practice Address - Country:US
Practice Address - Phone:817-375-0610
Practice Address - Fax:817-375-0640
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01046695207RN0300X
TXM5250207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196443904Medicaid
TX196443906Medicaid
P000789480OtherRAILROAD MEDICARE
TX7002130OtherCIGNA
TX7220017OtherAETNA
TX8AT814OtherBCBS
TX7002130OtherCIGNA
TX196443904Medicaid