Healthcare Provider Details

I. General information

NPI: 1073662268
Provider Name (Legal Business Name): JODI GOULD LEMESHEV M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 LEGACY DR STE 201
FRISCO TX
75034-6748
US

IV. Provider business mailing address

4040 LEGACY DR STE 201
FRISCO TX
75034-6748
US

V. Phone/Fax

Practice location:
  • Phone: 972-668-6705
  • Fax: 972-668-7308
Mailing address:
  • Phone: 972-668-6705
  • Fax: 972-668-7308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberL8794
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: