Provider Demographics
NPI:1740839190
Name:HOWARD, JACQUELINE ANN
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:ANN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 SE LOOP 410 APT 12203
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78220-2660
Mailing Address - Country:US
Mailing Address - Phone:210-355-8686
Mailing Address - Fax:210-783-8567
Practice Address - Street 1:707 SE LOOP 410 APT 12203
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78220-2660
Practice Address - Country:US
Practice Address - Phone:210-355-8686
Practice Address - Fax:210-783-8567
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX022469253Z00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care