Provider Demographics
NPI:1376689026
Name:DARBY-JETT, JULIE ANN (PA- C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:DARBY-JETT
Suffix:
Gender:F
Credentials:PA- C
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:DARBY-JETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:5050 COLLIN MCKINNEY PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1717
Mailing Address - Country:US
Mailing Address - Phone:214-673-2455
Mailing Address - Fax:
Practice Address - Street 1:5050 COLLIN MCKINNEY PKWY STE 202
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-1717
Practice Address - Country:US
Practice Address - Phone:214-673-2455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03111207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00658032OtherRAILROAD MEDICARE PTAN
TXQ33583Medicare UPIN