Individual
DR. JACQUELINE NICOLE BALDERAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3600 MEMORIAL BLVD, KERRVILLE, TX 78028-5819
(830) 896-2020
Mailing address
3600 MEMORIAL BLVD, KERRVILLE, TX 78028-5819
(830) 734-4647
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10055
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10055
TEXAS OPTOMETRY BOARD
TX
01
—
753741
NBEO TRACKING NUMBER
—
Enumeration date
07/23/2020
Last updated
07/14/2025
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