Individual
JAIMIE ELIZABETH LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
333 N. SANTA ROSA ST., SUITE CCF F3625, SAN ANTONIO, TX 78207
(210) 704-3910
Mailing address
333 N. SANTA ROSA ST., SUITE CCF F3625, SAN ANTONIO, TX 78207
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
V0028
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2021
Last updated
04/03/2024
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