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NPI Code Detail

MEDICARE: MS. JENNIFER JEAN APODACA PA-C

MEDICARE:  MS. JENNIFER JEAN APODACA  PA-C
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
1363AM0700XMedical Physician AssistantPA07386TX

General Provider Information

NPI Number : 1487939849
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER JEAN APODACA PA-C
Provider Business Mailing Address
First Line : 20403 LIATRIS LN
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78259-2251
Country : US
Telephone Number : 210-857-0427
Fax Number :
Provider Business Practice Location Address
First Line : 3100 SCHOFIELD RD
Second Line : BUILDING 1179
City : FORT SAM HOUSTON
State : TX
Zip : 78234-7577
Country : US
Telephone Number : 210-808-2457
Fax Number : 210-808-3515
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2011
Last Update Date : 10/08/2013

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Directions to “ MS. JENNIFER JEAN APODACA PA-C” Practice Location

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