Provider Demographics
NPI:1659402857
Name:PUENTE, JESSICA (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:PUENTE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 ESTERS RD
Mailing Address - Street 2:APT1701
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-9354
Mailing Address - Country:US
Mailing Address - Phone:214-642-5106
Mailing Address - Fax:
Practice Address - Street 1:2801 W DAVIS ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-2824
Practice Address - Country:US
Practice Address - Phone:214-337-3188
Practice Address - Fax:214-337-3180
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC10043111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation