Individual
DR. JACQUELYN RENEA PAETZOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
Mailing address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R6069
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
388562604
—
TX
Enumeration date
04/28/2014
Last updated
11/13/2019
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