Individual provider Active NPI

George Jeha, MD

  • Dermatology Physician
  • Lewisville, TX
National Provider Identifier
1407437965
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
V6036 Issued in TX
Practice address
1640 FM 544 Ste 100
Lewisville, TX 75056-7013
Phone
(972) 395-1101
NPI assigned
Apr 16, 2021
Last updated
Feb 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X V6036 TX Primary
MOHS-Micrographic Surgery Physician 207ND0101X V6036 TX

Addresses

Primary practice location

1640 FM 544 Ste 100
Lewisville, TX 75056-7013

Mailing address

7300 Ranch Road 2222, BLDG 1, Ste 200
Austin, TX 78730-3255
Phone (512) 628-0465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250313000018 TX Practitioner - Dermatology 9638550064 Reassigns benefits to 1 organization
I20260626004358 LA Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 9638550064

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epiphany Dermatology PAGroup PAC ID 3971827791, 106 clinicians
Dermatology Clinic a Professional Medical CorporationGroup PAC ID 6103856661, 13 clinicians

Practice addresses (Care Compare)

2504 Ridge Rd
Suite 102
Rockwall, TX 75087-2570
Phone (214) 771-3100

5326 O Donovan Dr
Baton Rouge, LA 70808-4691

5326 Odonovan Dr
Baton Rouge, LA 70808-4691
Phone (225) 769-7546

7106 New Sanger Rd
Waco, TX 76712-3928
Phone (254) 537-1265

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions58
Skin biopsy30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Epiphany Dermatology PA Dermatology CurrentSince Mar 1, 2025 Accepting new patients

Locations

7300 Ranch Road 2222
Bldg 1
Austin, TX 78730

1640 FM 544
Ste 100
Lewisville, TX 75056
Phone (972) 395-1101

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1407437965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 RANCH ROAD 2222, BLDG 1, STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787303255",
            "telephone_number": "512-628-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 FM 544 STE 100",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750567013",
            "telephone_number": "972-395-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEHA",
        "first_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-16",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "V6036",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TX",
            "license": "V6036",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

Verify at the official NPI Registry.