Individual
JACOB M VINTINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
2821 E PRESIDENT GEORGE BUSH HWY STE 404, RICHARDSON, TX 75082-4278
(214) 943-2200
(214) 943-2201
Mailing address
2821 E PRESIDENT GEORGE BUSH HWY STE 404, RICHARDSON, TX 75082-4278
(214) 943-2200
(214) 943-2201
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10479
TX
Other
Enumeration date
04/22/2016
Last updated
03/30/2021
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