Provider Demographics
NPI:1467064873
Name:JAHAN, ISHRAT (PA)
Entity Type:Individual
Prefix:
First Name:ISHRAT
Middle Name:
Last Name:JAHAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 GARRETTS WAY
Mailing Address - Street 2:
Mailing Address - City:MANCHACA
Mailing Address - State:TX
Mailing Address - Zip Code:78652-4507
Mailing Address - Country:US
Mailing Address - Phone:214-705-4183
Mailing Address - Fax:
Practice Address - Street 1:1301 SOLANA BLVD STE 2200
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:TX
Practice Address - Zip Code:76262-1769
Practice Address - Country:US
Practice Address - Phone:214-705-4183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant