Provider Demographics
NPI:1871521229
Name:MABREY, JAY DONALD (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:DONALD
Last Name:MABREY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3600 GASTON AVE
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-820-7010
Mailing Address - Fax:214-820-7015
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:SUITE 1101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1800
Practice Address - Country:US
Practice Address - Phone:214-820-7010
Practice Address - Fax:214-820-7015
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ2665207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102926603Medicaid
TX8BR111OtherBCBS
TX102926604Medicaid
TX8K6393OtherBCBS
TXP00368046Medicare PIN
TX8L2776Medicare PIN
TX8K6393OtherBCBS
TX8BR111OtherBCBS
TX102926603Medicaid