MEDICARE: JESSICA VEGA 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
1	363AM0700X	Medical Physician Assistant	PA14512	TX

General Provider Information

NPI Number	:	1013590660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA VEGA PA

Provider Business Mailing Address
First Line	:	104 W FLEETWOOD AVE
Second Line	:
City	:	LA FERIA
State	:	TX
Zip	:	78559-6295
Country	:	US
Telephone Number	:	956-244-7568
Fax Number	:	956-361-4998

Provider Business Practice Location Address
First Line	:	1722 S CAROLINA ST STE B
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550-8306
Country	:	US
Telephone Number	:	956-425-1368
Fax Number	:	956-425-1408

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2021
Last Update Date	:	06/08/2026

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Directions to “ JESSICA VEGA PA” Practice Location

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