Individual
JIALA BACLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1408 SHELBY CT, IRVING, TX 75061-7130
(214) 718-7050
(214) 441-3079
Mailing address
1408 SHELBY CT, IRVING, TX 75061-7130
(214) 718-7050
(214) 441-3079
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
705733
TX
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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