Healthcare Provider Details

I. General information

NPI: 1073304309
Provider Name (Legal Business Name): JASMINE ESTELLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 4TH ST FL 3
LUBBOCK TX
79430-0002
US

IV. Provider business mailing address

5717 119TH ST
LUBBOCK TX
79424-6147
US

V. Phone/Fax

Practice location:
  • Phone: 806-743-2340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number1050763
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1050763
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: