Provider Demographics
NPI:1104088244
Name:JAISWAL, DEVKI
Entity type:Individual
Prefix:DR
First Name:DEVKI
Middle Name:
Last Name:JAISWAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 FM 407 STE 302
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7239
Mailing Address - Country:US
Mailing Address - Phone:214-505-4385
Mailing Address - Fax:
Practice Address - Street 1:2940 FM 407 STE 302
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7239
Practice Address - Country:US
Practice Address - Phone:214-505-4385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0738207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine