Individual
JENNY PROPHETE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5120 LEGACY DR, PLANO, TX 75024-3399
(469) 613-1722
Mailing address
5120 LEGACY DR, PLANO, TX 75024-3399
(469) 613-1722
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
TX
Other
Enumeration date
12/13/2017
Last updated
03/18/2022
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