MEDICARE: JAZMIN ADI

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
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1912758400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAZMIN ADI

Provider Business Mailing Address
First Line	:	12255 UNIVERSITY DR STE 150
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-9489
Country	:	US
Telephone Number	:	972-542-4646
Fax Number	:	972-542-0909

Provider Business Practice Location Address
First Line	:	12255 UNIVERSITY DR STE 150
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-9489
Country	:	US
Telephone Number	:	972-542-4646
Fax Number	:	972-542-0909

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2024
Last Update Date	:	06/01/2026

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Directions to “ JAZMIN ADI ” Practice Location

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