Individual
MRS. JESSICA MARIE LONGORIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
555 S INTERNATIONAL BLVD STE B-100, WESLACO, TX 78596-9116
(956) 477-1515
Mailing address
151 E HWY 77, SAN BENITO, TX 78586-5232
(956) 361-4558
(956) 361-4998
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05888
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548592579
NPI
TX
05
—
341036702
—
TX
Enumeration date
02/01/2010
Last updated
09/06/2023
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