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General NPI Number Information
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NPI Number | 1255451720
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Entity Type | Organization
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Legal Business Name | JAYSHRI MEDICAL GROUP, PLLC
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 1911 ABRAMS PKWY SUITE A
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City | DALLAS
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State | TX
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Zip | 75214-6219
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Country | US
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Telephone | 214-824-6700
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Fax | 214-824-6701
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Provider Business Mailing Address
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Address Line | 1911 ABRAMS PKWY SUITE A
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City | DALLAS
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State | TX
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Zip | 75214-6219
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Country | US
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Telephone | 214-824-6700
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Fax | 214-824-6701
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Authorized Official
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Title or Position | MANAGER
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Name | JAYSHRI CHASMAWALA
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Credential | DO
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Telephone | 214-824-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | L7687
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License Number State | TX
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