Individual
JANIA LETISSE DUDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
18602 FM 1488 RD, SUITE 700, MAGNOLIA, TX 77354-8508
(281) 252-0013
Mailing address
PO BOX 1176, WALLER, TX 77484-1176
(936) 931-3448
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07532
TX
Other
Enumeration date
07/25/2012
Last updated
07/25/2012
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