Provider Demographics
NPI:1386096238
Name:JAGMIN, CHRISTOPHER LUCIEN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LUCIEN
Last Name:JAGMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8181 DOUGLAS AVE
Mailing Address - Street 2:#610
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6561
Mailing Address - Country:US
Mailing Address - Phone:214-265-8566
Mailing Address - Fax:
Practice Address - Street 1:8181 DOUGLAS AVE
Practice Address - Street 2:#610
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6561
Practice Address - Country:US
Practice Address - Phone:214-265-8566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-04
Last Update Date:2016-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6667207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine