Provider Demographics
NPI:1841946779
Name:FALCON, JAMIE TERESA (FNTP, RWS 3)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:TERESA
Last Name:FALCON
Suffix:
Gender:F
Credentials:FNTP, RWS 3
Other - Prefix:MRS
Other - First Name:JAMIE
Other - Middle Name:TERESA
Other - Last Name:CREEDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5713 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-0819
Mailing Address - Country:US
Mailing Address - Phone:956-245-7483
Mailing Address - Fax:
Practice Address - Street 1:5713 RIVER RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-0819
Practice Address - Country:US
Practice Address - Phone:956-245-7483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date: