Individual
MRS. JENNIFER MARIE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5323 HARRY HINES BOULEVARD, DALLAS, TX 75390-7208
(214) 645-3300
(214) 645-3301
Mailing address
P.O. BOX 845347, DALLAS, TX 75284-5347
(214) 645-3300
(214) 645-3301
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10427
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/04/2015
Last updated
05/12/2016
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