| Jerry Thomas Light Jr, MD | |
|
1604 Hospital Pkwy Ste 501, Bedford, TX 76022-6932 | |
| (817) 684-2700 | |
| (817) 684-2709 |
| Full Name | Jerry Thomas Light Jr |
|---|---|
| Gender | Male |
| Speciality | Surgery - Vascular Surgery |
| Location | 1604 Hospital Pkwy Ste 501, Bedford, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831198720 | NPI | - | NPPES |
| 046401803 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | K3785 (Texas) | Primary |
| Entity Name | Texas Health Physicians Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114395969 PECOS PAC ID: 4385535954 Enrollment ID: O20040323000759 |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry Thomas Light Jr, MD 1604 Hospital Pkwy Ste 501, Bedford, TX 76022-6932 Ph: (817) 684-2700 | Jerry Thomas Light Jr, MD 1604 Hospital Pkwy Ste 501, Bedford, TX 76022-6932 Ph: (817) 684-2700 |
Dr. Peter Edward Grays, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1909 Central Dr, Ste. 202, Bedford, TX 76021 Phone: 817-571-4620 Fax: 817-571-4701 | |
Collin D Gandillon, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1604 Hospital Pkwy Ste 501, Bedford, TX 76022 Phone: 817-684-2700 Fax: 817-684-2709 | |
Dr. Sajid Hussain Shah, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1604 Hospital Pkwy Ste 501, Bedford, TX 76022 Phone: 817-684-2700 Fax: 817-684-2709 | |
Dr. James D. Poettcker, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1604 Hospital Parkway, #505, Bedford, TX 76022 Phone: 817-267-2678 Fax: 817-354-0854 | |
Catherine Michelle Jennings, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1609 Hospital Pkwy, Bedford, TX 76022 Phone: 817-662-0008 | |
Benjamin Todd Drury, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2425 Highway 121, Bedford, TX 76021 Phone: 817-540-4477 Fax: 817-510-0185 |