Provider Demographics
NPI:1336763911
Name:JONES, ASIA KAMARI - SHADELL (CD, CPM, LM)
Entity Type:Individual
Prefix:
First Name:ASIA
Middle Name:KAMARI - SHADELL
Last Name:JONES
Suffix:
Gender:F
Credentials:CD, CPM, LM
Other - Prefix:
Other - First Name:ASIA
Other - Middle Name:
Other - Last Name:ODHAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4408 PATE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76119-3832
Mailing Address - Country:US
Mailing Address - Phone:682-203-9836
Mailing Address - Fax:
Practice Address - Street 1:4408 PATE DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76119-3832
Practice Address - Country:US
Practice Address - Phone:682-203-9836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-30
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
TX99514176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula