STACY R. MORETTA (NPI# 1639309461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639309461 |
| Entity Type | Individual |
| Full Name | STACY R. MORETTA |
| Credential | P.A. |
| Practice Address |
6161 N State Highway 161 Irving TX 75038 |
| Mailing Address |
6161 N State Highway 161 Irving TX 75038-2220 |
| Practice Telephone | 9722587499 |
| Practice Fax Number | 9722570897 |
| Mailing Telephone | 9722587499 |
| Mailing Fax Number | 9722570897 |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2018-08-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA06061 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE NUMBER | 467551YZNA | 01 |
| Street Address |
6161 N STATE HIGHWAY 161 |
| City | IRVING |
| State | TX |
| Zip Code | 75038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083687206 | Mary C Ward | Family Medicine | 6161 N State Highway 161, Irving, TX 75038 | 2006-02-08 |
| 1154952133 | George Larry Jones Jr. | Pharmacist | 6161 N State Highway 161, Irving, TX 75038-2220 | 2020-01-29 |
| 1508388679 | Cindi Ann Peters | Registered Nurse | 6161 N State Highway 161, Irving, TX 75038 | 2017-07-11 |
| 1700255684 | Tabetha Maslow | Nurse Practitioner | 6161 N State Highway 161, Irving, TX 75038 | 2015-09-21 |
| 1316262033 | Jennifer Garcia Mata | Physician Assistant | 6161 N State Highway 161, Irving, TX 75038 | 2010-04-06 |
| 1326363128 | Randi Dawn True | Physician Assistant | 6161 N State Highway 161, Irving, TX 75038 | 2010-04-05 |
| 1043458631 | Abigail Lewadowski Soto | Physician Assistant | 6161 N State Highway 161, Irving, TX 75038 | 2009-02-04 |
| 1073712329 | Healthcare Associates of Irving | Pharmacy | 6161 N State Highway 161, Irving, TX 75038-2220 | 2007-07-17 |
| 1346466943 | Cesar O. Torres | Family Medicine | 6161 N State Highway 161, Irving, TX 75038 | 2007-04-18 |
| 1467413625 | Healthcare Associates of Irving LLP | Family Medicine | 6161 N State Highway 161, Irving, TX 75038-2220 | 2006-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457959587 | S&w Primary Home Care | Home Health | 3921 Timberidge Drive, Irving, TX 75038 | 2020-10-12 |
| 1295372928 | Wecare Tlc | Clinic/Center | 777 Hidden Ridge, Irving, TX 75038 | 2019-12-02 |
| 1407369135 | North Texas Psychiatry Associates Pllc | Psychiatry & Neurology | 4020 N. Macarthur Blvd, Suite 122 - 153, Irving, TX 75038 | 2017-11-16 |
| 1164970745 | Young Men's Christian Association of Metropolitan Dallas | Health Educator | 1621 W Walnut Hill Ln, Irving, TX 75038 | 2016-09-13 |
| 1285086397 | Edge-md Holding Pllc | Family Medicine | 1200 W. Walnut Hill Lane, Suite 3950, Irving, TX 75038 | 2016-07-13 |
| 1912318445 | Alliance Neurodiagnostics, LLC | Clinic/Center | 4545 Fuller Dr Ste 200, Irving, TX 75038 | 2014-05-19 |
| 1790029841 | Paul Dean Allen | Counselor | 5525 N. Macarthur Blvd, Suite 800, Mhn Government Services, Irving, TX 75038 | 2012-11-15 |
| 1437403227 | Dashwood Pharmacy | Pharmacy | 1300 W. Walnut Hill Lane, Suite 163, Irving, TX 75038 | 2012-11-01 |
| 1265795538 | Michael Fooshee | Dentist | 3007 Skyway Circle North, Suite 100, Irving, TX 75038 | 2012-06-20 |
| 1205107273 | Sylviane Akenda Kasende | Nurse Practitioner | 2925 Skyway Circle N, Irving, TX 75038 | 2012-01-23 |
| Find all providers in zip 75038 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548810476 | Joyce Yan Chuen | Physician Assistant | 6161 State Highway 161, Suite 310, Irving, TX 75038-2220 | 2019-09-12 |
| 1982154829 | Oracle Health & Rehabilitation Center LLC | Physician Assistant | 1425 W Pioneer Dr Ste 112b, Irving, TX 75061-7124 | 2016-10-04 |
| 1922483866 | Ashley Halfast | Physician Assistant | 3412 Hidalgo St, Irving, TX 75062-6517 | 2015-07-21 |
| 1124449244 | Jeffin Alex | Physician Assistant | 4735 Byron Cir, Irving, TX 75038-6319 | 2013-12-16 |
| 1063841310 | Jwalant Patel | Physician Assistant | 6245 Love Dr, Apt 1526, Irving, TX 75039-4053 | 2013-11-07 |
| 1447565106 | Clara Graham | Physician Assistant | 7924 N Macarthur Blvd, # 3081, Irving, TX 75063-3736 | 2010-08-18 |
| 1144311002 | Lori Rae Wimberley | Physician Assistant | 122 Village Ctr, Irving, TX 75061-2647 | 2006-09-27 |
| 1376108944 | Tots 2 Teens Kid Care, Pllc | Physician Assistant | 3626 N Macarthur Blvd Ste 200, Irving, TX 75062-3643 | 2019-05-08 |
| 1518389980 | Karrah Alayne Black | Physician Assistant | 6161 N Highway 161, Irving, TX 75038 | 2014-01-20 |
| 1508107657 | Crystal Kittisopikul | Physician Assistant | 2021 N Macarthur Blvd, Suite 350, Irving, TX 75061-2219 | 2013-03-13 |
| Find all providers in IRVING | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.