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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