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NPI Code Detail

MEDICARE: CAROL A DEVITO P.A.

MEDICARE: CAROL A DEVITO P.A.
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 Assistant13777CA

General Provider Information

NPI Number : 1700901717
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL A DEVITO P.A.
Provider Business Mailing Address
First Line : 5080 SPECTRUM DR
Second Line : SUITE 1200 WEST
City : ADDISON
State : TX
Zip : 75001-4648
Country : US
Telephone Number : 972-364-8000
Fax Number : 214-775-4502
Provider Business Practice Location Address
First Line : 2555 S EAST AVE
Second Line :
City : FRESNO
State : CA
Zip : 93706-5104
Country : US
Telephone Number : 615-778-4066
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 10/07/2009

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Directions to “ CAROL A DEVITO P.A.” Practice Location

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