Individual
FANTA JALABAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2021 GUADALUPE ST STE 260, AUSTIN, TX 78705-5654
(646) 453-6777
Mailing address
4742 LONESTONE CIR, KATY, TX 77449-1540
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1126205
TX
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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