Provider Demographics
NPI:1932817020
Name:ZEPEDA, ALEXANDRIA RENEE (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:RENEE
Last Name:ZEPEDA
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 1:219 W KINGSLEY RD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-3448
Mailing Address - Country:US
Mailing Address - Phone:972-271-5544
Mailing Address - Fax:
Practice Address - Street 1:219 W KINGSLEY RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-3448
Practice Address - Country:US
Practice Address - Phone:972-271-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16672363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program