Active NPI
Alan B Jean, M.D.
- Diagnostic Radiology Physician
- Texarkana, TX
National Provider Identifier
1073504742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- G7247
- Practice address
- 4102 Richmond MDWS
Texarkana, TX 75503-0067 - Phone
- (903) 223-1014
- Fax
- (903) 223-1028
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | G7247 | TX | Primary |
Addresses
Primary practice location
4102 Richmond MDWS
Texarkana, TX 75503-0067
Mailing address
PO Box 5667
Texarkana, TX 75505-5667
Phone (903) 223-1014
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 117999601 | Medicaid | TX | |
| 105242001 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G7247 | TX | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333929600000",
"number": "1073504742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5667",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755055667",
"telephone_number": "903-223-1014",
"fax_number": "903-223-1028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4102 RICHMOND MDWS",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755030067",
"telephone_number": "903-223-1014",
"fax_number": "903-223-1028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEAN",
"first_name": "ALAN",
"middle_name": "B",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2012-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "G7247",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "117999601",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "105242001",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
- Joseph D James, D.D.S.
- Paul Mitchell James, CRNA
- Jay J Castle DDS PLLC
- Morgan M Jayaprabhu, FNP-C
- Sudheer M Jayaprabhu, MD
- James L Jean, M.D.
- Jeanne a. Field Miller D/B/a Summerhill Counseling Center
- Jeanne a. Field Miller Doing Business As Summerhill Counseling Center
- Jeff P Young MD PA
- Jeffory F Thomas, MD PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.