Provider Demographics
NPI:1780325449
Name:JANJUA, TYLER REHANA (NP)
Entity type:Individual
Prefix:MS
First Name:TYLER
Middle Name:REHANA
Last Name:JANJUA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TYLER
Other - Middle Name:R
Other - Last Name:SHRAIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5220 W UNIVERSITY DR STE 150
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7418
Mailing Address - Country:US
Mailing Address - Phone:972-984-1050
Mailing Address - Fax:972-984-1376
Practice Address - Street 1:1790 KING ARTHUR BLVD STE 120
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-2040
Practice Address - Country:US
Practice Address - Phone:972-984-1050
Practice Address - Fax:972-984-1050
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1060091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily