Individual
JESSICA AGWUMARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8062 FERGUSON RD, DALLAS, TX 75228-5848
(214) 327-6800
Mailing address
3804 MEREDITH LN, BALCH SPRINGS, TX 75180-5016
(214) 609-7985
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA09778
TX
363AM0700X
Medical Physician Assistant
PA09778
TX
Other
Enumeration date
08/11/2015
Last updated
06/05/2020
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