NPI 1245945153 · live from the CMS NPI Registry
Jeanine Azzo, PA-C
Physician Assistant in Flower Mound, TX. National Provider Identifier 1245945153, active.
NPI record
| NPI | 1245945153 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 4630 Long Prairie Rd Ste 210, Flower Mound, TX 75028 |
| Practice phone | 469-495-9112 |
| Mailing address | 1616 S Mustang Rd, Yukon, OK 73099 |
| Enumerated | January 16, 2023 |
| Last updated | October 17, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 4891 (OK) |
| Physician Assistant primary | 363A00000X | PA18155 (TX) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.