Healthcare Provider Details

I. General information

NPI: 1255784948
Provider Name (Legal Business Name): DA-SHU JIANG M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2016
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 FOREST LN STE A331
DALLAS TX
75230-2538
US

IV. Provider business mailing address

7777 FOREST LN STE A331
DALLAS TX
75230-2538
US

V. Phone/Fax

Practice location:
  • Phone: 972-566-7860
  • Fax: 972-566-6673
Mailing address:
  • Phone: 972-566-7860
  • Fax: 972-566-6673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DA-SHU JIANG
Title or Position: OWNER
Credential: MD
Phone: 972-566-7860