Individual
ASHA S JAYACHANDRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6421 MCCART AVE, FORT WORTH, TX 76133-4702
(817) 263-7500
Mailing address
801 7TH AVE, REVENUE MANAGEMENT, FORT WORTH, TX 76104-2733
(682) 885-4157
(682) 885-1903
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L6077
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750369203
GRP NPI NUMBER
—
Enumeration date
09/02/2006
Last updated
07/08/2007
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