Provider Demographics
NPI:1013590660
Name:VEGA, JESSICA (PA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:VEGA
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:104 W FLEETWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LA FERIA
Mailing Address - State:TX
Mailing Address - Zip Code:78559-6295
Mailing Address - Country:US
Mailing Address - Phone:956-244-7568
Mailing Address - Fax:956-361-4998
Practice Address - Street 1:1722 S CAROLINA ST STE B
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8306
Practice Address - Country:US
Practice Address - Phone:956-425-1368
Practice Address - Fax:956-425-1408
Is Sole Proprietor?:No
Enumeration Date:2021-05-02
Last Update Date:2024-09-10
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Provider Licenses
StateLicense IDTaxonomies
TXPA14512363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant