Individual provider · NPI-1

Yesenia Acevedo, PA-C

Physician Assistant · Fort Worth, TX

NPI number1942808688
StatusActive
Last updated in NPPESOct 15, 2020

Details

NPI
1942808688
Entity type
Individual (NPI-1)
Name
Yesenia Acevedo
Credential
PA-C
Sex
Female
Sole proprietor
No
Enumeration date
Oct 14, 2020
Certification date
Oct 15, 2020
Last updated
Oct 15, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant––Yes

Practice location

1200 Woodhaven Blvd
Fort Worth, TX 76112-2376

Phone 817-429-8300

Mailing address

122 W John Carpenter Fwy Ste 420
Irving, TX 75039-2014

Phone 972-957-3000

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