Individual
GINA JASSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1616 AZALEA DR, TEMPLE, TX 76502
(254) 771-0852
Mailing address
1616 AZALEA DR, TEMPLE, TX 76502-2774
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
144128
TX
Other
Enumeration date
09/03/2018
Last updated
09/03/2018
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