MEDICARE: JESSICA VICTORIA WEBSTER

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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1275264483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA VICTORIA WEBSTER

Provider Business Mailing Address
First Line	:	3802 SARATOGA BLVD APT 913
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78415-5829
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3802 SARATOGA BLVD APT 913
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78415-5829
Country	:	US
Telephone Number	:	859-533-8616
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2022
Last Update Date	:	05/07/2025

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Directions to “ JESSICA VICTORIA WEBSTER ” Practice Location

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