Provider Demographics
NPI:1144537606
Name:KOO, JASMINE JAMIN (MD)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:JAMIN
Last Name:KOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:JAMIN
Other - Middle Name:
Other - Last Name:KOO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1601 E PFLUGERVILLE PKWY STE 3201
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-7349
Mailing Address - Country:US
Mailing Address - Phone:206-450-6845
Mailing Address - Fax:
Practice Address - Street 1:1601 E PFLUGERVILLE PKWY STE 3201
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7349
Practice Address - Country:US
Practice Address - Phone:206-450-6845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-04
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC1641862085R0204X
TXR48632085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology