SearchTexas225700000X

Jacob Petersen

NPI 1659108231 · on the registry since 2024 · sole proprietor

Practice

Address
4331 Jon Cunningham Blvd
El Paso, TX 79934
Phone
(915) 345-4800

Registry record

Primary taxonomy
225700000X
225700000X
Licence states on file
TX
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-09-17

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas