Provider Demographics
NPI:1962285411
Name:CORTES, JOSE LUIS JR (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:LUIS
Last Name:CORTES
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 413
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447-0413
Mailing Address - Country:US
Mailing Address - Phone:832-421-0375
Mailing Address - Fax:
Practice Address - Street 1:9401 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1407
Practice Address - Country:US
Practice Address - Phone:713-970-4326
Practice Address - Fax:713-970-6021
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA17122363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant