| Jessica Louise Licea, | |
|
510 N Hewitt Dr, Hewitt, TX 76643-3038 | |
| (254) 420-5000 | |
| (254) 420-5007 |
| Full Name | Jessica Louise Licea |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 510 N Hewitt Dr, Hewitt, Texas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508623273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA18063 (Texas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Louise Licea, Po Box 844658, Dallas, TX 75284-4658 Ph: (254) 724-2111 | Jessica Louise Licea, 510 N Hewitt Dr, Hewitt, TX 76643-3038 Ph: (254) 420-5000 |
Marcus John Wauson, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 510 N Hewitt Dr, Hewitt, TX 76643 Phone: 254-420-5000 Fax: 254-420-5007 | |
Jessica Carrier, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 510 N Hewitt Dr, Hewitt, TX 76643 Phone: 254-420-5000 Fax: 254-420-5007 | |
Micah D Adams, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 510 N Hewitt Dr, Hewitt, TX 76643 Phone: 254-420-5000 Fax: 254-420-5007 |