Individual
ANDREA PAVIA-JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
610 W CENTERVILLE RD, GARLAND, TX 75041-5419
(214) 501-3494
Mailing address
3230 I 30 STE 100, MESQUITE, TX 75150-2662
(972) 682-1791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12535
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403452201
—
TX
01
—
PA12535
PA LICENSE
TX
Enumeration date
11/27/2018
Last updated
03/07/2023
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