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General NPI Number Information
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NPI Number | 1245392232
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Entity Type | Individual
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Provider Name | JENNIFER RACQUEL JUPIO D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 06/01/2009
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Provider Practice Location Address
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Address Line | 7758 W TIDWELL RD STE. #126
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City | HOUSTON
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State | TX
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Zip | 77040-5741
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Country | US
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Telephone | 713-690-2555
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Fax | 713-690-2777
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Provider Business Mailing Address
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Address Line | 7758 W TIDWELL RD STE. #126
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City | HOUSTON
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State | TX
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Zip | 77040-5741
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Country | US
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Telephone | 713-690-2555
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Fax | 713-690-2777
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 21917
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License Number State | TX
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