Provider Demographics
NPI:1417519471
Name:QUIROS, JENNIFER ERIN (MMSC, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ERIN
Last Name:QUIROS
Suffix:
Gender:F
Credentials:MMSC, PA-C
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Mailing Address - Street 1:9301 N CENTRAL EXPY STE 500
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0805
Mailing Address - Country:US
Mailing Address - Phone:214-220-2468
Mailing Address - Fax:469-232-9738
Practice Address - Street 1:9301 N CENTRAL EXPY STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0805
Practice Address - Country:US
Practice Address - Phone:214-220-2468
Practice Address - Fax:469-232-9738
Is Sole Proprietor?:No
Enumeration Date:2019-06-30
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA56881363A00000X
TXPA15740363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant