Provider Demographics
NPI:1609479799
Name:KESSENICH, JESLIE CUARESMA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESLIE
Middle Name:CUARESMA
Last Name:KESSENICH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 OAK TRL
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76262-8062
Mailing Address - Country:US
Mailing Address - Phone:202-403-9921
Mailing Address - Fax:
Practice Address - Street 1:35 ARTA DR
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:TX
Practice Address - Zip Code:76262-2013
Practice Address - Country:US
Practice Address - Phone:817-491-7364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54243183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist