Healthcare Provider Details

I. General information

NPI: 1598567299
Provider Name (Legal Business Name): JESSICA S PRETTYMAN MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 8TH AVE STE 200
FORT WORTH TX
76104-2500
US

IV. Provider business mailing address

PO BOX 733784
DALLAS TX
75373-3784
US

V. Phone/Fax

Practice location:
  • Phone: 682-885-3633
  • Fax:
Mailing address:
  • Phone: 682-885-6483
  • Fax: 682-885-3113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number22671
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: