Provider Information for 1437857174
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
YEVETTE JACQUES MS
Sex: Female
NPI: 1437857174
Last Updated: 2024-05-22
Certification Date: 2024-05-22
Certification Date: 2024-05-22
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1437857174 | ||||||||||||
| Enumeration Date | 2023-02-22 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 163781 FORT WORTH, TX 76161-3781 United States Phone: 682-651-7621 | Fax:817-887-3409 | ||||||||||||
| Primary Practice Address | 1285 N MAIN ST STE 101-5 MANSFIELD, TX 76063-1511 United States Phone: 682-651-7621 | Fax:817-887-3409 | ||||||||||||
| Secondary Practice Address(es) | |||||||||||||
| Health Information Exchange |
| ||||||||||||
| Other Identifiers |
| ||||||||||||
| Taxonomy |
|