Individual
PROF. JERRAL G HOPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN,CRNA
Contact information
Practice address
3500 GASTON AVE, CRNA, DALLAS, TX 75246-2017
(214) 820-2170
(214) 820-7977
Mailing address
11123 WONDERLAND TRL, DALLAS, TX 75229-3944
(214) 654-0612
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
572255
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1587289-03
—
TX
01
—
85329U
BCBS
TX
Enumeration date
07/24/2006
Last updated
12/06/2007
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