NPI age
19 years
Enumerated 2007-01-05
Across 2220 active physician assistant providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00157011 | TEXAS DPS REGISTRATION NUMBER |
| 01 (TX) | PA03396 | TEXAS PA LICENSE |
| 01 | 1034587 | NCCPA CERTIFICATION ID NUMBER |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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