Individual
JENICA M ROSE-STINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
136 EL CHICO TRL STE 102, WILLOW PARK, TX 76087-8864
(817) 441-5412
(817) 441-9354
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1855
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M8294
TX
Other
Enumeration date
05/04/2007
Last updated
04/19/2021
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