Individual
JAI GEORGY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
234 W CAMPBELL RD, RICHARDSON, TX 75080-3512
(940) 758-5695
Mailing address
1620 ROCK RIDGE RD, LUCAS, TX 75002-8367
(586) 556-5509
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704199015
MI
163WM0705X
Medical-Surgical Registered Nurse
1018930
TX
363L00000X
Nurse Practitioner
Primary
4704199015
MI
363LP2300X
Primary Care Nurse Practitioner
1018930
TX
Other
Enumeration date
04/12/2019
Last updated
09/05/2022
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