Individual
JOSCELYNE POULETTE BAZALDUA DEL ANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1511 E KANTUNIL AVE, ALTON, TX 78573-0903
(956) 888-7380
Mailing address
1511 E KANTUNIL AVE, ALTON, TX 78573-0903
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
347827
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790847531
—
TX
Enumeration date
09/17/2019
Last updated
04/08/2020
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