JACOB LUSTGARTEN

FORT WORTH, TX
NPI1467869982
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: TX  PA09208)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2014-07-16
Last Update Date2021-04-13
Business Address
JACOB LUSTGARTEN PA-C
1500 COOPER ST
FORT WORTH, TX 76104-2710
Phone number: 682-885-7080
Mailing Address
JACOB LUSTGARTEN PA-C
PO BOX 733784
DALLAS, TX 75373-3784
Phone number: 682-885-1855
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