Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NI0013X | Independent Medical Examiner | 6988 | TX |
N | 111NR0400X | Rehabilitation Chiropractor | 6988 | TX |
Y | 111NX0100X | Occupational Health | 6988 | TX |
NPI | 1538348305 |
---|---|
Provider Name | Jennifer Douglin |
First Address | Dallas, TX 75203-2914 |
Second Address | Dallas, TX 75203-2914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2007 |
Last Update Date | 30/10/2007 |