Provider Demographics
NPI:1063854560
Name:MONTOYA, JACQUELINE YVETTE (MPAS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:YVETTE
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:YVETTE
Other - Last Name:PADRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1710 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6646
Mailing Address - Country:US
Mailing Address - Phone:956-969-2536
Mailing Address - Fax:
Practice Address - Street 1:1710 E 8TH ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6646
Practice Address - Country:US
Practice Address - Phone:956-969-2536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08391363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical