NPI age
19 years
Enumerated 2006-07-09
Across 2220 active physician assistant providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 1017116 | PA CERTIFICATION |
| 01 (WA) | 0224086 | LABOR & INDUSTRIES |
| 01 (WA) | 8945047 | CRIME VICTIMS |
| 01 (WA) | PA10001357 | PA LICENSE |
| 05 (WA) | 8465411 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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