Graduated: 1990
NPI: 1437157419
Practice Locations (2)
PHYSICIAN SERVICES OF JACKSBORO PA
709 N 4TH ST
JACKSBORO, TX 764581132
8175650922
LEGACY HEALTHCARE SERVICES INC
800 COLLEGE PKWY
LEWISVILLE, TX 750773503
9724208543
Source: CMS National Downloadable File, September 2026.