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NPI Code Detail

MEDICARE: ZAQUIA SHENAETHIA MACKEY PA

MEDICARE: ZAQUIA SHENAETHIA MACKEY PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1699329128
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZAQUIA SHENAETHIA MACKEY PA
Provider Business Mailing Address
First Line : 6200 OVERTON RIDGE BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-3614
Country : US
Telephone Number : 817-361-1991
Fax Number : 817-977-7520
Provider Business Practice Location Address
First Line : 6200 OVERTON RIDGE BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-3614
Country : US
Telephone Number : 817-361-1991
Fax Number : 817-977-7520
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2019
Last Update Date : 10/07/2020

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Directions to “ ZAQUIA SHENAETHIA MACKEY PA” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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