Individual
JORGE MIGUEL BARAJAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
2931 HARNEY PATH, FORT SAM HOUSTON, TX 78234-7674
(760) 807-5202
Mailing address
10248 CRYSTAL VW, UNIVERSAL CITY, TX 78148-4637
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
11/29/2022
Last updated
01/12/2023
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