Individual
JAKE NATHANIEL LICHTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6202 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 645-3999
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
S5686
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2018
Last updated
09/04/2024
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