Individual
JACQUELYN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
15400 SOUTHWEST FWY, SUITE 300, SUGAR LAND, TX 77478-3875
(281) 491-3636
Mailing address
PO BOX 841969, DALLAS, TX 75284-1969
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
546586
TX
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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