Individual
MRS. JENNIFER ACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1807 W SLAUGHTER LN STE 490, AUSTIN, TX 78748-6208
(512) 346-6611
(512) 406-7351
Mailing address
4515 SETON CENTER PKWY STE 215, AUSTIN, TX 78759-5785
(512) 338-3826
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA08071
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
387045301
—
TX
05
—
387045302
—
TX
Enumeration date
12/20/2012
Last updated
10/04/2018
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