Individual
ADRIANA JOCELYN DACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5439 RAY ELLISON BLVD, SAN ANTONIO, TX 78242-2219
(210) 334-3711
Mailing address
3750 COMMERCIAL AVE, SAN ANTONIO, TX 78221-3117
(210) 334-3711
(210) 271-7208
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA18495
TX
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
09/05/2024
Last updated
10/23/2024
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