Individual
MRS. JACQUELINE E BVLGARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
221 3RD ST W BLDG 1040, JBSA RANDOLPH, TX 78150-4800
(808) 282-2080
Mailing address
2931 HARNEY PATH RM 247, JBSA FT SAM HOUSTON, TX 78234-7674
(808) 282-2080
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1045517
—
Other
Enumeration date
12/30/2005
Last updated
11/09/2020
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