Larussa, Jacquelyn

Larussa, Jacquelyn is an sole proprietor health care provider with primary practice located at 1650 W College St , Grapevine TX 76051. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Larussa, Jacquelyn can be contacted via phone (817) 481-1588.

Contact Information

Primary practice address
1650 W College St Grapevine TX 76051
Phone: (817) 481-1588
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X S0492 Texas

Profile Details

NPI number 1093178360
LBN Legal business name Larussa, Jacquelyn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 3rd, 2016
Last updated Aug 8th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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