Individual
DR. JEAN NERVA DORTILUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3500 HILLCREST DR STE 7, WACO, TX 76708-3144
(254) 424-9523
Mailing address
3500 HILLCREST DR STE 7, WACO, TX 76708-3144
(254) 424-9523
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
P4438
TX
2084P0804X
Child & Adolescent Psychiatry Physician
P4438
TX
208D00000X
General Practice Physician
P4438
TX
Other
Enumeration date
01/05/2009
Last updated
05/27/2019
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