NPI age
17 years
Enumerated 2008-08-18
Across 11022 active physician assistant providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | NCCPA 1082641 | NATIONAL COMMISSION OF CERTIFICATION OF PHYSICIAN ASSISTANTS |
| 01 (TX) | PA05803 | TEXAS STATE LICENSE |
Part of a multi-provider practice. 22 other active providers share this practice address in NPPES.
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