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1891293031
LOGAN JACOB FONTENOT
HOUSTON, TX
NPI
1891293031
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: TX AP136242)
Enumeration Date
2018-01-23
Last Update Date
2018-01-23
Business Address
LOGAN JACOB FONTENOT CRNA
1500 CITYWEST BLVD STE 300
HOUSTON, TX 77042-2549
Phone number: 713-620-4000
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Mailing Address
LOGAN JACOB FONTENOT CRNA
PO BOX 650865
DALLAS, TX 75265-0865
Phone number: 713-620-4000
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