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Individual

DR. DAISY JACQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
1041 NNE LOOP 323, TYLER, TX 75708-2014
(903) 535-7200
Mailing address
1041 NNE LOOP 323, TYLER, TX 75708-2014
(903) 535-7200

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
61895
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
61895
TEXAS STATE BOARD OF PHARMACY
TX
Enumeration date
01/09/2018
Last updated
05/10/2018
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