Individual
DR. TANIA JESMINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-7001
Mailing address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-4472
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01082515A
IN
207R00000X
Internal Medicine Physician
Primary
S4505
TX
390200000X
Student in an Organized Health Care Education/Training Program
S4505
TX
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/31/2016
Last updated
08/10/2022
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