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NPI Code Detail

MEDICARE: JOSEFA DEL CARMEN JARAVALERO EFDA

MEDICARE:   JOSEFA DEL CARMEN JARAVALERO  EFDA
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
1126800000XDental Assistant1852TX

General Provider Information

NPI Number : 1912356346
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEFA DEL CARMEN JARAVALERO EFDA
Provider Business Mailing Address
First Line : 4431 68TH ST
Second Line :
City : FORT HOOD
State : TX
Zip : 76544-5042
Country : US
Telephone Number : 254-287-1225
Fax Number : 254-287-9685
Provider Business Practice Location Address
First Line : 4431 68TH ST
Second Line :
City : FORT HOOD
State : TX
Zip : 76544-5042
Country : US
Telephone Number : 254-287-1225
Fax Number : 254-287-9685
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2016
Last Update Date : 06/07/2016

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Directions to “ JOSEFA DEL CARMEN JARAVALERO EFDA” Practice Location

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