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NPI Code Detail

MEDICARE: JACQUELINE WOLOSKI MD

MEDICARE: JACQUELINE WOLOSKI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207V00000XObstetrics & Gynecology PhysicianV3460TX

General Provider Information

NPI Number : 1023690625
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE WOLOSKI MD
Provider Business Mailing Address
First Line : 404 FRIO ST
Second Line :
City : MISSION
State : TX
Zip : 78572-7455
Country : US
Telephone Number : 915-215-8000
Fax Number :
Provider Business Practice Location Address
First Line : 4801 ALBERTA AVE
Second Line :
City : EL PASO
State : TX
Zip : 79905-2707
Country : US
Telephone Number : 956-222-8345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2021
Last Update Date : 01/21/2026

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Directions to “ JACQUELINE WOLOSKI MD” Practice Location

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