Individual provider Active NPI

Leticia Lynette Cortes, PA-C

  • Physician Assistant
  • Burleson, TX
National Provider Identifier
1124639000
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16185 Issued in TX
Practice address
11797 South Fwy Ste 246
Burleson, TX 76028-7035
Phone
(817) 615-8627
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA16185 TX Primary

Addresses

Primary practice location

11797 South Fwy Ste 246
Burleson, TX 76028-7035

Mailing address

305 W FM 1187 Apt 512
Crowley, TX 76036-4090
Phone (682) 256-5082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA16185TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Huguley Medical Associates CurrentSince Nov 13, 2022 Accepting new patients

Locations

11803 South Fwy
Ste 205
Burleson, TX 76028
Phone (817) 293-1200

11797 South Fwy
Ste 246
Burleson, TX 76028
Phone (817) 551-5539

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1124639000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W FM 1187 APT 512",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760364090",
            "telephone_number": "682-256-5082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11797 SOUTH FWY STE 246",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287035",
            "telephone_number": "817-615-8627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTES",
        "first_name": "LETICIA",
        "middle_name": "LYNETTE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.