Individual
DR. BENJAMIN PAUL JAQUISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, MS-01-390F, TEMPLE, TX 76508-0001
(775) 750-6083
Mailing address
75 PRINGLE WAY, STE 1002, RENO, NV 89502-1475
(775) 323-7500
(775) 789-9208
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301094774
MI
2086S0129X
Vascular Surgery Physician
Primary
P9206
TX
Other
Enumeration date
11/29/2010
Last updated
06/13/2016
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