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Individual

JESSE DAVID CARLUCCI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
303 LANTERN BEND DR, HOUSTON, TX 77090-2823
(518) 852-4284
Mailing address
16912 TABLELAND TRL, CONROE, TX 77385-2010
(518) 852-4284

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2110477
TX

Other

Enumeration date
07/18/2022
Last updated
07/18/2022
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