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General NPI Number Information
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NPI Number | 1184401267
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Entity Type | Organization
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Legal Business Name | JD COE III FAMILY NURSE PRACTITIONER SERVICES PLLC
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 1203 WELBY CT
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City | LAREDO
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State | TX
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Zip | 78041-1951
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Country | US
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Telephone | 956-794-8840
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Fax | 956-794-8844
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Provider Business Mailing Address
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Address Line | PO BOX 451367
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City | LAREDO
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State | TX
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Zip | 78045-0033
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Country | US
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Telephone | 956-794-8840
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSE COE
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Credential | FNP
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Telephone | 956-489-1040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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