Individual
JESSICA CORINNE KOWALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3801 SCOTT AND WHITE DR, KILLEEN, TX 76543-5252
(254) 680-1100
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA055973
PA
363A00000X
Physician Assistant
Primary
PA09288
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
381621YT2M
MEDICARE PTAN
TX
Enumeration date
01/24/2013
Last updated
07/08/2015
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