Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | P2921 | TX |
N | 207NS0135X | Procedural Dermatology | P2921 | TX |
NPI | 1396935391 |
---|---|
Provider Name | Dr. Jessica M Saucier |
First Address | Rockwall, TX 75032-0005 |
Second Address | Rockwall, TX 75032-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2007 |
Last Update Date | 17/11/2015 |