MEDICARE: DR. JASPREET SINGH MAVI PHARMD

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	183500000X	Pharmacist	63352	TX

General Provider Information

NPI Number	:	1659974640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASPREET SINGH MAVI PHARMD

Provider Business Mailing Address
First Line	:	9509 SAW DUST DR
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-4971
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4122 LYNDON B JOHNSON FWY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5703
Country	:	US
Telephone Number	:	972-363-3700
Fax Number	:

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

Provider Enumeration Date	:	11/20/2020
Last Update Date	:	11/20/2020

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