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General NPI Number Information
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NPI Number | 1518002237
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Entity Type | Organization
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Legal Business Name | JAIME J. VASQUEZ, D.O., P.A.
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2929 WELBORN ST
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City | DALLAS
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State | TX
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Zip | 75219-4931
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Country | US
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Telephone | 214-528-1083
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Fax | 214-528-3252
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Provider Business Mailing Address
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Address Line | 2929 WELBORN ST
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City | DALLAS
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State | TX
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Zip | 75219-4931
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Country | US
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Telephone | 214-528-1083
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Fax | 214-528-3252
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAIME JAVIER VASQUEZ
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Credential | D.O.
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Telephone | 214-528-1083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | H4764
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License Number State | TX
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