Members Only
Non Members
To become a member of Jefferson Physician Group, please read, complete and sign the following documents and return to the Jefferson office.
To Become a Member
Texas Standard Credentialing Form
Physician’s Rights Agreement
Provider Participation Agreement
HIPAA Business Associate Agreement
Fax: (972) 380-7043 or call (972) 380-7070
(To download right click the above link and save target as...)
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