MEDICARE: DR. CHRISTOPHER LUCIEN JAGMIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G6667	TX

General Provider Information

NPI Number	:	1386096238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER LUCIEN JAGMIN M.D.

Provider Business Mailing Address
First Line	:	8181 DOUGLAS AVE
Second Line	:	#610
City	:	DALLAS
State	:	TX
Zip	:	75225-6561
Country	:	US
Telephone Number	:	214-265-8566
Fax Number	:

Provider Business Practice Location Address
First Line	:	8181 DOUGLAS AVE
Second Line	:	#610
City	:	DALLAS
State	:	TX
Zip	:	75225-6561
Country	:	US
Telephone Number	:	214-265-8566
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2016
Last Update Date	:	07/04/2016

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