Healthcare Provider Details

I. General information

NPI: 1487536363
Provider Name (Legal Business Name): JASON SENG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11720 CHAMPION CREEK DR
FRISCO TX
75036-0938
US

IV. Provider business mailing address

11720 CHAMPION CREEK DR
FRISCO TX
75036-0938
US

V. Phone/Fax

Practice location:
  • Phone: 469-529-0910
  • Fax: 214-778-5562
Mailing address:
  • Phone: 469-529-0910
  • Fax: 214-778-5562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1023021
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: