Provider Demographics
NPI:1033173802
Name:ATKINS, JANA MCGUIRE (PA)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:MCGUIRE
Last Name:ATKINS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:MCGUIRE
Other - Last Name:PERETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:5310 HARVEST HILL RD STE 290
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-5826
Mailing Address - Country:US
Mailing Address - Phone:214-420-0672
Mailing Address - Fax:214-736-0512
Practice Address - Street 1:9808 N BEACH ST STE 600
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6184
Practice Address - Country:US
Practice Address - Phone:817-741-7515
Practice Address - Fax:817-741-7516
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03188363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86N614Medicare ID - Type Unspecified
TXP44315Medicare UPIN
TXP44315Medicare UPIN
TX197757103Medicaid