MRS. Jamie D Wade

NPI #1720778251 in South Texarkana, Texas

Provider Information

NPI Number: 1720778251
Entity Type: Individual
Name: MRS. Jamie D Wade
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Contractor
Enumeration Date: May 9, 2023
Last Updated: May 9, 2023

Practice Location

Address: 86 PR 25162
City: South Texarkana
State: Texas
ZIP Code: 75501-2074
Phone: (903) 244-6184

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X
Contractor	171W00000X	Primary

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