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Individual
JACQUE ANGERSTEIN
Active
Individual
JACQUE ANGERSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K7623
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111964605
—
TX
01
—
74-2956327
TAX ID #
—
01
—
8AJ087
INDIVIDUAL BCBS OF TX ID
TX
Enumeration date
12/21/2005
Last updated
09/13/2021
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