Provider Demographics
NPI:1861035560
Name:ALCAZAREN, JINGLE ALCALA (MSN, APRN, AGPCNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JINGLE
Middle Name:ALCALA
Last Name:ALCAZAREN
Suffix:
Gender:F
Credentials:MSN, APRN, AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 SHADOW FALLS LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3410
Mailing Address - Country:US
Mailing Address - Phone:281-857-5262
Mailing Address - Fax:
Practice Address - Street 1:8785 W BELLFORT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-2403
Practice Address - Country:US
Practice Address - Phone:713-771-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142731363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology