Provider Demographics
NPI:1306854369
Name:MALAY, JADE (FNP, DC)
Entity Type:Individual
Prefix:
First Name:JADE
Middle Name:
Last Name:MALAY
Suffix:
Gender:F
Credentials:FNP, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 N DALLAS PKWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5993
Mailing Address - Country:US
Mailing Address - Phone:972-378-0383
Mailing Address - Fax:972-403-3434
Practice Address - Street 1:290 S PRESTON RD STE 240
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9835
Practice Address - Country:US
Practice Address - Phone:972-378-0383
Practice Address - Fax:972-403-3434
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX6310111N00000X
TXAP143609363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042789001OtherMEDICAID TX
TX085689001Medicaid
TX83Z420OtherBCBS
TXU61021Medicare UPIN
TX83Z420OtherBCBS