Provider Demographics
NPI:1619659570
Name:ZARATE, KIRSTEN LEIGH (PA-C)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:LEIGH
Last Name:ZARATE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:
Other - Last Name:FISHBECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:403 MALLARD LN
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-1210
Practice Address - Country:US
Practice Address - Phone:512-352-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA17189363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical