Individual
ALICIA MARIE JAKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-7500
Mailing address
1002 ATHENS ST, CASTROVILLE, TX 78009-2913
(210) 313-0578
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
931336
TX
163WG0600X
Gerontology Registered Nurse
931336
TX
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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