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NPI Code Detail

MEDICARE: MICHELLE MARIE JASPER PA-C

MEDICARE: MICHELLE MARIE JASPER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA02010TX

General Provider Information

NPI Number : 1164786273
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE MARIE JASPER PA-C
Provider Business Mailing Address
First Line : 700 N PEARL ST STE N510
Second Line :
City : DALLAS
State : TX
Zip : 75201-2863
Country : US
Telephone Number : 214-580-7277
Fax Number : 214-999-9363
Provider Business Practice Location Address
First Line : 700 N PEARL ST STE N208
Second Line :
City : DALLAS
State : TX
Zip : 75201-7430
Country : US
Telephone Number : 214-999-9355
Fax Number : 214-999-9363
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2012
Last Update Date : 07/10/2023

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Directions to “ MICHELLE MARIE JASPER PA-C” Practice Location

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