Individual
OTEKA JACKSON-CENALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 E TRAVIS ST STE 112, MARSHALL, TX 75670-4280
(318) 393-5407
Mailing address
505 E TRAVIS ST, MARSHALL, TX 75670-4258
(318) 393-5407
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
747761
TX
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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