Provider Demographics
NPI:1518317148
Name:JUBORI, MAYSSARA (MD)
Entity type:Individual
Prefix:
First Name:MAYSSARA
Middle Name:
Last Name:JUBORI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAYSSARA
Other - Middle Name:
Other - Last Name:AL-JUBORI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3721 S STONEBRIDGE DR UNIT 703
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-0234
Mailing Address - Country:US
Mailing Address - Phone:313-550-4997
Mailing Address - Fax:
Practice Address - Street 1:3721 S STONEBRIDGE DR UNIT 703
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-0234
Practice Address - Country:US
Practice Address - Phone:313-550-4997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME145237207R00000X
TXT1974207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1245923325Medicaid