1821188293 NPI number — JASON L WEST MD

Table of content: JASON L WEST MD (NPI 1821188293)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821188293 NPI number — JASON L WEST MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEST
Provider First Name:
JASON
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821188293
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6513 PRESTON RD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75024-2688
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-608-2025
Provider Business Mailing Address Fax Number:
972-608-2032

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3537 S I 35 E
Provider Second Line Business Practice Location Address:
SUITE 320
Provider Business Practice Location Address City Name:
DENTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76210-6800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-243-7000
Provider Business Practice Location Address Fax Number:
940-243-7001
Provider Enumeration Date:
10/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  026288 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: M7750 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00745290 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 198816403 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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