Individual
JACQUELYNN T ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
904 FORD ST, LLANO, TX 78643-2345
(830) 953-1700
(830) 953-1717
Mailing address
3600 N EDWARDS ST APT 2216, MIDLAND, TX 79705-5229
(254) 466-9859
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA18346
TX
Other
Enumeration date
08/22/2022
Last updated
11/20/2025
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