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General NPI Number Information
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NPI Number | 1700330735
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Entity Type | Individual
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Provider Name | JADE LAZAROW PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/08/2016
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 7120 E COUNTY LINE RD
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80126-3926
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Country | US
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Telephone | 720-446-5891
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9101 SUITE 600
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City | COPPELL
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State | TX
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Zip | 75019-9494
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Country | US
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Telephone | 972-745-7500
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Fax | 972-471-0700
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10698
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0008255
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License Number State | CO
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