Provider Demographics
NPI:1124074018
Name:OCHOA, KRISTY E (PA)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:E
Last Name:OCHOA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 N. CAGE
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577
Mailing Address - Country:US
Mailing Address - Phone:956-283-1889
Mailing Address - Fax:956-283-7014
Practice Address - Street 1:807 N. CAGE
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577
Practice Address - Country:US
Practice Address - Phone:956-283-1889
Practice Address - Fax:956-283-7014
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04250363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA04250OtherTEXAS STATE MED. LIC
TX613536/GROUP PTANMedicare PIN