Individual provider · Type 1 NPI

Jacob Samuel Modesitt

Student in an Organized Health Care Education/Training Program · Dallas, TX

NPI number 1023719986 Active

Practice location

3500 Gaston Ave
Dallas, TX 75246-2017

Call (559) 308-9231 Map

Mailing address

2217 4th Ave N
Great Falls, MT 59401-2803

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

803 other providers at this address

Other student in an organized health care education/training program providers in Dallas

See all in Dallas →

About NPI 1023719986

Jacob Samuel Modesitt's National Provider Identifier is 1023719986, issued on Mar 16, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Dallas, TX. The record was last updated on Apr 21, 2024.