NPI 1003195793
Jacqueline Denise Sparks
Practice location
- Address
- 12552 Canyon Hill Dr, Willis, TX 77318-4641
- Phone
- (936) 445-9141
- Mailing address
- 12552 Canyon Hill Dr, Willis, TX 77318-5742
Registered specialties
Community/Behavioral Health Agency
Primary
Registry record
- NPI
- 1003195793
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 11 Aug 2011
- Record last updated
- 11 Aug 2011
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.