Individual provider Active NPI

Jessica Agwumaro, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1417323643
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09778 Issued in TX
Practice address
3001 Palm Way Ste D134
Austin, TX 78758-7963
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Aug 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA09778 TX
Physician Assistant 363A00000X PA09778 TX Primary

Addresses

Primary practice location

3001 Palm Way Ste D134
Austin, TX 78758-7963

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (888) 663-6331

Other practice location 1

8062 Ferguson Rd
Dallas, TX 75228-5848
Phone (214) 327-6800

Other practice location 2

2201 N Central Expy Ste 125
Richardson, TX 75080-2701
Phone (214) 377-1790

Other practice location 3

2550 Gray Falls Dr Ste 150
Houston, TX 77077-6687
Phone (713) 422-2920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151124002553 TX Practitioner - Physician Assistant 8325348279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

104 S Main St
Keller, TX 76248-5003
Phone (214) 295-9385

2310 W University Dr
Suite 1500
Denton, TX 76201-1650
Phone (940) 220-5901

377 W Campbell Rd
Suite 100
Richardson, TX 75080-3695
Phone (469) 232-2945

3821 W Spring Creek Pkwy
Plano, TX 75023-3808
Phone (972) 599-0077

4501 Lemmon Ave
Dallas, TX 75219-2145
Phone (469) 672-4238

4524 W Bailey Boswell Rd
Fort Worth, TX 76179-4319
Phone (817) 720-9685

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA09778TXMDMedical Physician Assistant

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": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1417323643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "888-663-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 PALM WAY STE D134",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787587963",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8062 Ferguson Rd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752285848",
            "country_code": "US",
            "telephone_number": "214-327-6800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2201 N Central Expy Ste 125",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750802701",
            "country_code": "US",
            "telephone_number": "214-377-1790",
            "fax_number": "720-598-0440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2550 Gray Falls Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770776687",
            "country_code": "US",
            "telephone_number": "713-422-2920",
            "fax_number": "281-720-8809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGWUMARO",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA09778",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.