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1720621071
JEFFREY JESSADA LERTDILOK
CARROLLTON, TX
NPI
1720621071
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX AP142915)
Enumeration Date
2019-10-18
Last Update Date
2019-10-18
Business Address
JEFFREY JESSADA LERTDILOK FNP-C
4100 FAIRWAY DR STE 320
CARROLLTON, TX 75010-6537
Phone number: 972-236-7608
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Mailing Address
JEFFREY JESSADA LERTDILOK FNP-C
4132 CATAWBA AVE
CARROLLTON, TX 75010-1196
Phone number: 972-746-8250
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