is a Physician Assistant in Hickory Creek, Texas. practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for is 1821100017. The last update date is .
's current location address is 3600 Fm 2181 Ste 100, Hickory Creek, Texas. You can contact this provider via phone number 9404984422 and fax number 9403211045. The mailing address for is 3600 Fm 2181 Ste 100, Hickory Creek, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 3600 Fm 2181 Ste 100, Hickory Creek, Texas |
| Phone Number | 9404984422 |
| Fax Number | 9403211045 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1821100017 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 3600 Fm 2181 Ste 100 |
|---|---|
| City | Hickory Creek |
| State | Texas (TX) |
| Post Code | 750657636 |
| Phone Number | 9404984422 |
| Fax Number | 9403211045 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA02545 |
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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 perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| P00149080 | RRM |
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