Individual
MRS. JACQUELYN KRYSTHNA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8220 WALNUT HILL LN STE 710, DALLAS, TX 75231-4427
(214) 368-6707
(214) 368-1804
Mailing address
7610 N STEMMONS FWY STE 600, DALLAS, TX 75247-4228
(214) 689-5960
(469) 713-8084
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03619
TX
Other
Enumeration date
02/15/2006
Last updated
09/23/2020
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