Individual
JACQUES A ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2617 BOLTON BOONE DR, SUITE B, DESOTO, TX 75115-2074
(972) 709-1781
(972) 709-1782
Mailing address
2617 BOLTON BOONE DR, SUITE B, DESOTO, TX 75115-2074
(972) 709-1781
(972) 709-1782
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G6995
TX
207QA0505X
Adult Medicine Physician
Primary
G6995
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
G6995
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140352946
—
TX
Enumeration date
08/17/2006
Last updated
02/23/2010
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