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NPI Code Detail

MEDICARE: JESSICA MACWAN

MEDICARE: JESSICA MACWAN
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
1363LF0000XFamily Nurse Practitioner1141907TX

General Provider Information

NPI Number : 1275308314
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MACWAN
Provider Business Mailing Address
First Line : 5655 W SPRING CREEK PKWY STE 200
Second Line :
City : PLANO
State : TX
Zip : 75024-4175
Country : US
Telephone Number : 972-599-9600
Fax Number : 972-599-9696
Provider Business Practice Location Address
First Line : 5655 W SPRING CREEK PKWY STE 200
Second Line :
City : PLANO
State : TX
Zip : 75024-4175
Country : US
Telephone Number : 972-599-9600
Fax Number : 972-599-9696
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2023
Last Update Date : 12/12/2025

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Directions to “ JESSICA MACWAN ” Practice Location

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