Provider Demographics
NPI:1699488957
Name:WARDEN, JAZMINE (DC)
Entity type:Individual
Prefix:
First Name:JAZMINE
Middle Name:
Last Name:WARDEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 N MACARTHUR BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6400
Mailing Address - Country:US
Mailing Address - Phone:469-565-2354
Mailing Address - Fax:
Practice Address - Street 1:4000 N MACARTHUR BLVD STE 111
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6400
Practice Address - Country:US
Practice Address - Phone:469-565-2354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15365111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor