Individual
JOVANNY IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4001 DILLARD CT, JOSHUA, TX 76058-5813
(817) 226-0262
Mailing address
4001 DILLARD CT, JOSHUA, TX 76058-5813
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
321984
TX
Other
Enumeration date
02/19/2018
Last updated
01/06/2020
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