Individual
MRS. JACQUELYNN ANTOINETTE LONGSHAW
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2828 DUKE OF GLOUCESTER ST, SUITE 106, DESOTO, TX 75115-2067
(972) 298-3888
(972) 296-0838
Mailing address
867 WINDY MEADOW DR, DESOTO, TX 75115-7551
(972) 230-1754
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K2061
TX
Other
Enumeration date
03/29/2006
Last updated
07/08/2007
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