Individual
JACKIE LOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1617 BUSCHONG RD, HOUSTON, TX 77039
(713) 569-6435
Mailing address
1617 BUSCHONG ST, HOUSTON, TX 77039-1206
(713) 569-6435
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
165924
TX
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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