Kristina Widjaja in Dallas - Physician Assistant
Kristina Widjaja - NPI 1942319173
Kristina Widjaja is a Physician Assistant in Dallas, Texas. Kristina Widjaja practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Kristina Widjaja is 1942319173. The last update date is 2007-07-08.
Kristina Widjaja's current location address is 4500 S Lancaster Rd, Dallas, Texas. You can contact this provider via phone number 2148572171 and fax number 2148572166. The mailing address for Kristina Widjaja is 4500 S Lancaster Rd, Dallas, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kristina Widjaja |
|---|---|
| Address | 4500 S Lancaster Rd, Dallas, Texas |
| Phone Number | 2148572171 |
| Fax Number | 2148572166 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1942319173 |
|---|---|
| Provider Enumeration Date | 2006-08-30 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4500 S Lancaster Rd |
|---|---|
| City | Dallas |
| State | Texas (TX) |
| Post Code | 752167167 |
| Phone Number | 2148572171 |
| Fax Number | 2148572166 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA03752 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Post Comment/ Review Below
What is the unique 10-digit identification code issued to Kristina Widjaja by the Centers for Medicare & Medicaid Services?
The Kristina Widjaja has been assigned the NPI (National Provider Identifier) 1942319173 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical address where Kristina Widjaja is geographically located?
The Kristina Widjaja is physically situated at the following location: 4500 S Lancaster Rd, Dallas, TX, 752167167.
What is the area of specialization for Kristina Widjaja, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Kristina Widjaja is Physician Assistant, and the corresponding taxonomy code that categorizes this area of expertise is 363A00000X.
On what date was the 1942319173 assigned to Kristina Widjaja?
The Kristina Widjaja was issued its 1942319173 on 2006-08-30, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Kristina Widjaja, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Kristina Widjaja, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2007-07-08.
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