Jorge L Candiotti, PA-C
Physician Assistant in Grapevine, TX. Individual provider (NPI-1).
NPI number1245877679
StatusActive
Last updated in NPPESMay 3, 2024
Details
- NPI
- 1245877679
- Entity type
- Individual (NPI-1)
- Name
- Jorge L Candiotti
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 4, 2019
- Certification date
- May 3, 2024
- Last updated
- May 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA17258 | TX | Yes |
| 363A00000X | Physician Assistant | MA061288 | PA |
Other names
- Jorge Luis Candiotti Herrera (Former Name)
Practice location
1604 Lancaster DrGrapevine, TX 76051-3544
Phone 855-893-5637
Mailing address
602 Leighton CtMars, PA 16046-7108
Phone 412-841-0723
Other practice locations
12311 Perry Hwy
Wexford, PA 15090-8344
Wexford, PA 15090-8344
Phone 878-332-4159
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All 59 Physician Assistant providers in Grapevine · All 1,669 providers in Grapevine
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