Medina, Jaqueline
Medina, Jaqueline is an sole proprietor health care provider with primary practice located at 2780 Fm 365 Suite C, Port Arthur TX 77640. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Medina, Jaqueline can be contacted via phone (409) 332-4701.Contact Information
Primary practice address
2780 Fm 365 Suite C
Port Arthur TX 77640
Phone: (409) 332-4701
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 36599 | Texas |
Profile Details
| NPI number | 1477167419 |
|---|---|
| LBN Legal business name | Medina, Jaqueline |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 8th, 2020 |
| Last updated | Sep 8th, 2020 - about 4 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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