Provider Demographics
NPI:1649906744
Name:JULIE DARBY-JETT MPAS PA-C LLC
Entity type:Organization
Organization Name:JULIE DARBY-JETT MPAS PA-C LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MIARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-202-5027
Mailing Address - Street 1:2005 CHESSINGTON LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-9052
Mailing Address - Country:US
Mailing Address - Phone:214-673-2455
Mailing Address - Fax:469-651-0041
Practice Address - Street 1:5050 COLLIN MCKINNEY PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-1717
Practice Address - Country:US
Practice Address - Phone:214-202-5027
Practice Address - Fax:469-651-0041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty