Provider Demographics
NPI:1821188293
Name:WEST, JASON L (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:L
Last Name:WEST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6513 PRESTON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2688
Mailing Address - Country:US
Mailing Address - Phone:972-608-2025
Mailing Address - Fax:972-608-2032
Practice Address - Street 1:3537 S I 35 E
Practice Address - Street 2:SUITE 320
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6800
Practice Address - Country:US
Practice Address - Phone:940-243-7000
Practice Address - Fax:940-243-7001
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2022-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA026288207P00000X
TXM7750208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00745290OtherRAILROAD MEDICARE
TX198816403Medicaid
TX8L10018Medicare PIN