Provider Demographics
NPI:1134605132
Name:JAISON, PHILSY (DNP)
Entity type:Individual
Prefix:MRS
First Name:PHILSY
Middle Name:
Last Name:JAISON
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 GUS THOMASSON RD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-2232
Mailing Address - Country:US
Mailing Address - Phone:214-221-0855
Mailing Address - Fax:972-354-8736
Practice Address - Street 1:4450 GUS THOMASSON RD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2232
Practice Address - Country:US
Practice Address - Phone:214-221-0855
Practice Address - Fax:972-354-8736
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11531363LW0102X
TX1204722363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health