Provider Demographics
NPI:1417369349
Name:ZIMMERMAN, JACQUELINE DOZIER (DO)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:DOZIER
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 PINE ST STE 4A
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2450
Mailing Address - Country:US
Mailing Address - Phone:325-670-4020
Mailing Address - Fax:325-670-3174
Practice Address - Street 1:1904 PINE ST STE 4A
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2450
Practice Address - Country:US
Practice Address - Phone:325-670-4020
Practice Address - Fax:325-670-3174
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10051113207V00000X
TXR7153207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology