Individual
MRS. JENNIFER GARCIA MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6161 N STATE HIGHWAY 161, IRVING, TX 75038
(972) 258-7499
(972) 257-0897
Mailing address
6161 N STATE HIGHWAY 161, IRVING, TX 75038-2220
(972) 258-7499
(972) 257-0897
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06031
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1319262033
TXB109485
TX
Enumeration date
04/06/2010
Last updated
08/24/2018
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