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1568728103
JACQUELINE FONTENOT BUTLER
LONGVIEW, TX
NPI
1568728103
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Former Name
JACQUELINE RENEE FONTENOT
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: TX Q2519)
Enumeration Date
2012-04-09
Last Update Date
2019-10-21
Business Address
JACQUELINE FONTENOT BUTLER MD
2901 N FOURTH ST EMERGENCY ROOM
LONGVIEW, TX 75605
Phone number: 903-758-1818
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Mailing Address
JACQUELINE FONTENOT BUTLER MD
2901 N FOURTH ST EMERGENCY ROOM
LONGVIEW, TX 75605
Phone number: 903-758-1818
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