Provider Demographics
NPI:1932266988
Name:CHASMAWALA, JAYSHRI (DO)
Entity Type:Individual
Prefix:DR
First Name:JAYSHRI
Middle Name:
Last Name:CHASMAWALA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 S CARRIER PKWY
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-3702
Mailing Address - Country:US
Mailing Address - Phone:972-262-5272
Mailing Address - Fax:972-262-1921
Practice Address - Street 1:1801 S CARRIER PKWY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-3702
Practice Address - Country:US
Practice Address - Phone:972-262-5272
Practice Address - Fax:972-262-1921
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7687207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187617901Medicaid
TX187617901Medicaid
TXI45764Medicare UPIN