Individual
JESUS GREGORIO CARRERA BOADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
2200 N LOOP 336 W APT 814, CONROE, TX 77304-3691
(936) 320-4210
Mailing address
2200 N LOOP 336 W APT 814, CONROE, TX 77304-3691
(936) 320-4210
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
23-580
TX
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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