Healthcare Provider Details

I. General information

NPI: 1619389517
Provider Name (Legal Business Name): MADIHA JAWWAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2026 W UNIVERSITY DR
DENTON TX
76201-0644
US

IV. Provider business mailing address

2026 W UNIVERSITY DR
DENTON TX
76201-0644
US

V. Phone/Fax

Practice location:
  • Phone: 940-320-8100
  • Fax:
Mailing address:
  • Phone: 940-320-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0000059499
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: