Provider Demographics
NPI:1275022394
Name:IRISH, JAZMINE A (MD)
Entity type:Individual
Prefix:
First Name:JAZMINE
Middle Name:A
Last Name:IRISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 LAKEPOINTE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-6470
Mailing Address - Country:US
Mailing Address - Phone:800-835-2362
Mailing Address - Fax:
Practice Address - Street 1:1945 LAKEPOINTE DR STE 100
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-6470
Practice Address - Country:US
Practice Address - Phone:855-732-5181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA194987207Q00000X
TXU0601207Q00000X
FLME149668207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine