Individual
GUILLA AEQUIELLE SANTOS JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6201 HARRY HINES BLVD, DALLAS, TX 75390-0001
(214) 645-8300
Mailing address
9802 CHASEFIELD DR, ROCKWALL, TX 75087-8753
(972) 835-5242
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1108869
TX
Other
Enumeration date
02/01/2023
Last updated
11/07/2024
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