Individual
JESSICA ELENA GORROSTIETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1121 E PARK, LINDALE, TX 75771-7089
(903) 228-3292
Mailing address
1121 E PARK, LINDALE, TX 75771-7089
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
932497
TX
Other
Enumeration date
10/16/2018
Last updated
10/16/2018
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