Healthcare Provider Details

I. General information

NPI: 1649562109
Provider Name (Legal Business Name): DA-SHU JIANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUE JIANG MD

II. Dates (important events)

Enumeration Date: 05/03/2011
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 NumberQ7566
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: