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General NPI Number Information
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NPI Number | 1679059950
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Entity Type | Individual
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Provider Name | RACHEL JAISON
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Gender | Female
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 8210 WALNUT HILL LN STE 306
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City | DALLAS
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State | TX
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Zip | 75231-4419
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Country | US
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Telephone | 469-646-8880
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Fax | 469-646-8884
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Provider Business Mailing Address
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Address Line | 9900 N CENTRAL EXPY STE 225
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City | DALLAS
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State | TX
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Zip | 75231-0918
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Country | US
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Telephone | 469-646-8880
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Fax | 469-646-8884
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP136920
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License Number State | TX
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