Individual
MR. JACOB WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
5026 POOL RD, DENISON, TX 75020-2803
(903) 465-3624
Mailing address
5026 POOL RD, DENISON, TX 75020-2803
(903) 465-3624
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1008163
TX
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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