AUDREY RAQUEL NELSON

FORT WORTH, TX
NPI1003961202
Other NameAUDREY CUSTODIO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: TX  PA10397)
Enumeration Date2007-01-25
Last Update Date2016-06-10
Business Address
Mrs. AUDREY RAQUEL NELSON PA
901 HEMPHILL ST
FORT WORTH, TX 76104-3111
Phone number: 817-332-4060
Mailing Address
Mrs. AUDREY RAQUEL NELSON PA
P.O. BOX 961205
FORT WORTH, TX 76161-1205
Phone number: 817-740-8400
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