Basic Information
| Provider Information | |||||||||
| NPI: | 1184042871 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BREKKE | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | PAUL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3300 OAK LAWN AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752194265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122523535 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3000 N INTERSTATE 35 | ||||||||
| Address2: | |||||||||
| City: | DENTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9408987000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2014 | ||||||||
| LastUpdateDate: | 07/06/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | R4370 | TX | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.