Individual
DR. JENNIFER MIN-WEN YIN BASHOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 W. IH 635, SUITE 220, IRVING, TX 75063
(972) 481-6363
(972) 406-2732
Mailing address
400 W. IH 635, SUITE 220, IRVING, TX 75063
(972) 481-6363
(972) 406-2732
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L5985
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158442701
—
TX
01
—
8J0302
BCBS
TX
Enumeration date
07/10/2006
Last updated
08/20/2012
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