Provider Demographics
NPI:1750354924
Name:APPLE, JEFFREY M (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:APPLE
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 1:1010 W 40TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-4010
Mailing Address - Country:US
Mailing Address - Phone:512-459-8753
Mailing Address - Fax:512-483-6807
Practice Address - Street 1:1010 W 40TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4010
Practice Address - Country:US
Practice Address - Phone:512-459-8753
Practice Address - Fax:512-483-6807
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK444012086S0129X
TXK9991208600000X
TN419682086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CA882OtherBLUECROSS BLUESHIELD OF TX
6444260OtherCIGNA
7103941OtherAETNA
TN3000373Medicaid
6444260OtherCIGNA
TX74-1796484OtherCTVS TAX ID NUMBER
TN3000373Medicaid
TX8CA882OtherBLUECROSS BLUESHIELD OF TX
TX8L17632Medicare PIN