JACQUELINE S O'DONALD, M.D., PA
Medical Practice at Richmond Rd, Texarkana, TX

License number
Texas L3496
Category
Medical Practice
Type
Specialist
Owner
Name: MRS. LISA ANN CARLTON CCA, CMIS
Title: INSURANCE/BILLING
Phone: (903) 831-3033
Address
Address
3510 Richmond Rd STE 100, Texarkana, TX 75503
National Provider ID: 1134432412
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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JACQUELINE S. O'DONALD, M.D., PA

2014 Galleria Oaks Dr, Texarkana, TX 75503

Status:
Inactive
Registration:
Feb 22, 2005
State ID:
0800457847
Business type:
Professional Association
Director, Member, President:
Jacqueline S. O'donald Director, Member, President, inactive
Agent:
Jacqueline S. O'donald,2014 Galleria Oaks Dr, Texarkana, TX 75503 (Physical)
TIN:
32035446056

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