Individual
JACQUELINE F FOURNIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
27760 RANCH ROAD 12, BLDG 1, DRIPPING SPRINGS, TX 78620
(512) 829-9118
(512) 406-7301
Mailing address
6210 E US HWY 290, STE 420 - CREDENTIALING, AUSTIN, TX 78723-1098
(512) 338-3826
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K2903
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104596504
—
TX
05
—
104596505
—
TX
05
—
104596506
—
TX
05
—
104596507
—
TX
05
—
200013510A
—
OK
Enumeration date
10/13/2006
Last updated
08/19/2019
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