Individual
JESSICA BASURTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1605 S 31ST ST TEMPLE TX 76508, TEMPLE, TX 76508-0001
(469) 506-2665
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
(254) 215-9722
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA19532
TX
Other
Enumeration date
08/15/2023
Last updated
01/12/2026
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