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1164716072
JOHNNY MALCOLM HASSERODT
CORPUS CHRISTI, TX
NPI
1164716072
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: TX 674744)
Enumeration Date
2011-06-08
Last Update Date
2016-08-03
Business Address
-- JOHNNY MALCOLM HASSERODT NP
13725 NORTHWEST BLVD STE 260
CORPUS CHRISTI, TX 78410-5123
Phone number: 361-387-5161
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Mailing Address
-- JOHNNY MALCOLM HASSERODT NP
PO BOX 261017
CORPUS CHRISTI, TX 78426-1017
Phone number: 361-387-5161
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