Most Relevant Information
Provider Data
| NPI Number: | 1003507377 |
| Provider Name: | PHILLIP JACOB TREXEL |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/17/2023 |
| Last Updated: | 05/17/2023 |
Provider Practice Location
1100 WILFORD HALL LOOP BLDG 455459
JBSA LACKLAND
TX
782365638
Practice Location Phone/Fax
| Phone: | 2102925972 |
| Fax: |
Provider Mailing Location
1100 WILFORD HALL LOOP BLDG 455459
JBSA LACKLAND
TX
782365638
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |