Provider Demographics
NPI:1659772267
Name:CUCCIO, JESSICA (PA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:CUCCIO
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Gender:F
Credentials:PA
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Mailing Address - Street 1:16605 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 285
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3501
Mailing Address - Country:US
Mailing Address - Phone:281-313-0031
Mailing Address - Fax:281-313-0032
Practice Address - Street 1:16605 SOUTHWEST FWY
Practice Address - Street 2:SUITE 285
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3501
Practice Address - Country:US
Practice Address - Phone:281-313-0031
Practice Address - Fax:281-313-0032
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2022-04-28
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Provider Licenses
StateLicense IDTaxonomies
TXPA09934363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8393NMOtherBCBSTX