NPI 1003251497 · live from the CMS NPI Registry
Jan Petrasek, M.D., Ph.D.
Internal Medicine, Gastroenterology in Dallas, TX. National Provider Identifier 1003251497, active.
NPI record
| NPI | 1003251497 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Gastroenterology 207RG0100X |
| Practice location | 5201 Harry Hines Blvd, Graduate Medical Education, Dallas, TX 75235 |
| Practice phone | 214-590-8058 |
| Mailing address | 2500 N State St, Jackson, MS 39216 |
| Enumerated | April 30, 2013 |
| Last updated | February 17, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine, Gastroenterology | 207RG0100X | 27717 (MS) |
| Internal Medicine | 207R00000X | 27717 (MS) |
| Student in an Organized Health Care Education/Training Program | 390200000X | BP10047494 (TX) |
| Internal Medicine, Gastroenterology primary | 207RG0100X | Q8602 (TX) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.