Individual
JACQUELINE LABOE GARDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1300 W TERRELL AVE, FORT WORTH, TX 76104
(817) 702-9000
(817) 702-5167
Mailing address
PO BOX 732973, DALLAS, TX 75373-2973
(817) 702-2450
(817) 702-8445
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
P1307
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340728001
—
TX
01
—
8EM258
BCBS
TX
Enumeration date
06/16/2010
Last updated
05/29/2019
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