Individual
JEANINE AZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4630 LONG PRAIRIE RD STE 210, FLOWER MOUND, TX 75028-1964
(469) 495-9112
Mailing address
1616 S MUSTANG RD, YUKON, OK 73099-0304
(405) 256-0501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4891
OK
363A00000X
Physician Assistant
Primary
PA18155
TX
Other
Enumeration date
01/16/2023
Last updated
10/17/2024
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