Provider Demographics
NPI:1114102092
Name:JAMAL, AYESHA (MD)
Entity Type:Individual
Prefix:DR
First Name:AYESHA
Middle Name:
Last Name:JAMAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3504 SPRINGBRANCH DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2430
Mailing Address - Country:US
Mailing Address - Phone:972-268-0591
Mailing Address - Fax:
Practice Address - Street 1:5252 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7822
Practice Address - Country:US
Practice Address - Phone:469-764-6950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101850207R00000X
MDD0067373207R00000X
TXN2580207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine