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General NPI Number Information
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NPI Number | 1023331196
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Entity Type | Individual
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Provider Name | EXA LEE RINCON PA
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Gender | Female
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 5939 HARRY HINES BLVD.
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City | DALLAS
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State | TX
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Zip | 75390
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Country | US
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Telephone | 214-645-2696
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 845347
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City | DALLAS
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State | TX
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Zip | 75284-5347
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA06574
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License Number State | TX
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