MS. KRISTINA WIDJAJA PA-C
NPI 1942319173
Physician Assistant in Dallas, TX

Q: What is Kristina Widjaja's NPI number?

The NPI number for Kristina Widjaja is 1942319173. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Q: What is Kristina Widjaja's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kristina Widjaja was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 30, 2006

4500 S LANCASTER RD, DALLAS, TX 75216(214) 857-2171(214) 857-2166 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Ms. Kristina Widjaja Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KRISTINA WIDJAJA PA-C (NPI 1942319173) is an individual physician assistant in Dallas, Texas, licensed in Texas (PA03752) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1942319173

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMS. KRISTINA WIDJAJACredential: PA-C

Location Address4500 S LANCASTER RDDallas, TX 75216-7167

Mailing Address4500 S Lancaster RdDallas, TX 75216-7167 · (214) 857-2171 · Fax (214) 857-2166

Phone(214) 857-2171

Fax(214) 857-2166

Sole ProprietorNo

Enumeration DateAugust 30, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1942319173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in TX · PA03752

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 perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

4500 S LANCASTER RD, Dallas, TX 75216

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DALLAS VETERANS ADMINISTRATION MEDICAL CENTER

General Acute Care Hospital