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Jesse Bruton III
Student in an Organized Health Care Education/Training Program in Fayetteville, Texas
NPI 1538734751

Jesse Bruton III is a Student in an Organized Health Care Education/Training Program based in Fayetteville, TX. Jesse Bruton III practices in Fayetteville, TX. The NPI Number for Jesse Bruton III is 1538734751 and holds a License No. 1003730 (Texas).

The current practice location address for Jesse Bruton III is 1845 S Fm 1291, Fayetteville, TX and can be reached out via phone at 325-518-1710.

Location: 1845 S Fm 1291, Fayetteville, TX, 78940-5175
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538734751
Provider Name
Jesse Bruton III
Credential
Provider Entity Type
Individual
Gender
Male
Address
1845 S Fm 1291, Fayetteville, TX, 78940-5175
Phone Number
325-518-1710
Fax Number
Provider Enumeration Date
05/20/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1003730 01 TX TEXAS BOARD OF NURSING
institution
Provider Business Practice Location Address Details
Address
1845 S Fm 1291
City
Fayetteville
State
Texas
Zip
78940-5175
Phone Number
325-518-1710
Fax Number
person
Provider Business Mailing Address Details
Address
1845 S Fm 1291
City
Fayetteville
State
Texas
Zip
78940-5175
Phone Number
325-518-1710
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
1003730 (Texas)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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