Individual
JOSE L IGLESIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-7080
(682) 885-7085
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6163
(682) 885-7347
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
J4231
TX
Other
Enumeration date
11/09/2005
Last updated
04/13/2021
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