Individual
DR. JACQUELINE DANIELLE VIDOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 539-9582
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-1598
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01073696A
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
R9034
TX
Other
Enumeration date
04/14/2011
Last updated
09/05/2024
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