Individual provider · NPI-1

Jackeline Grimaldo

Spec/Tech, Health Info · San Antonio, TX

NPI number1760077358
StatusActive
Last updated in NPPESMar 4, 2021

Details

NPI
1760077358
Entity type
Individual (NPI-1)
Name
Jackeline Grimaldo
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 4, 2021
Certification date
Mar 4, 2021
Last updated
Mar 4, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246Y00000X Spec/Tech, Health Info––Yes

Other names

  • Jackeline Perez (Former Name)

Practice location

6298 Lockhill Rd Unit 1004
San Antonio, TX 78240-2053

Phone 210-279-0875 · Fax 210-806-7576

Mailing address

6298 Lockhill Rd Unit 1004
San Antonio, TX 78240-2053

Phone 210-279-0875 · Fax 210-806-7576

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