Individual
JENNIFER BAILEY POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7777 FOREST LN, BUILDING D, SUITE 400, DALLAS, TX 75230-2505
(972) 566-7790
(972) 566-5819
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04401
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181617501
—
TX
05
—
181617502
—
TX
01
—
P01824297
RAILROAD
TX
Enumeration date
06/09/2006
Last updated
05/18/2017
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