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Individual
JESSICA D FUENTES
Active
Individual
JESSICA D FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10849
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
365229901
—
TX
01
—
365229902
CSHCN
TX
Enumeration date
09/21/2016
Last updated
09/16/2024
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