Provider Demographics
NPI:1861483000
Name:SIERRA, ARACELI (PA-C)
Entity Type:Individual
Prefix:
First Name:ARACELI
Middle Name:
Last Name:SIERRA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 NOGALITOS
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78225-2337
Mailing Address - Country:US
Mailing Address - Phone:210-533-0257
Mailing Address - Fax:210-531-9488
Practice Address - Street 1:9811 HUEBNER RD BLDG 2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3255
Practice Address - Country:US
Practice Address - Phone:210-533-0257
Practice Address - Fax:210-534-0890
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03620363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX369068YS18OtherMEDICARE PTAN
TXPA03620OtherSTATE LICENSE
TX181022801Medicaid
TX8D9003Medicare PIN