Provider Demographics
NPI:1598037855
Name:ESPINOSA, JESSICA LIZET (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LIZET
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:222 W. LAS COLINAS BLVD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039
Mailing Address - Country:US
Mailing Address - Phone:972-957-3000
Mailing Address - Fax:214-941-7818
Practice Address - Street 1:18470 BLANCO RD STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4992
Practice Address - Country:US
Practice Address - Phone:210-898-4345
Practice Address - Fax:210-783-9598
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07655363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX349167YXETMedicare PIN