Individual
JANA ELIZABETH DEJESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-0531
Mailing address
7575 AUTUMN PARK, SAN ANTONIO, TX 78249-4240
(210) 577-0657
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
BP10071301
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP10071301
PHYSICIAN IN TRAINING PERMIT
TX
Enumeration date
05/03/2020
Last updated
05/03/2020
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