Holly Jen Tyson in Lubbock - Physician Assistant
Holly Jen Tyson - NPI 1699819953
Holly Jen Tyson is a Physician Assistant in Lubbock, Texas. Holly Jen Tyson practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Holly Jen Tyson is 1699819953. The last update date is 2007-07-08.
Holly Jen Tyson's current location address is 3811 24th St, Lubbock, Texas. You can contact this provider via phone number 8067960202 and fax number 8067960496. The mailing address for Holly Jen Tyson is 3811 24th St, Lubbock, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Holly Jen Tyson |
|---|---|
| Address | 3811 24th St, Lubbock, Texas |
| Phone Number | 8067960202 |
| Fax Number | 8067960496 |
| Sole Proprietor | Y |
| Credentials | P.A.-C |
NPI Number Detail
| NPI Number | 1699819953 |
|---|---|
| Provider Enumeration Date | 2007-02-19 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3811 24th St |
|---|---|
| City | Lubbock |
| State | Texas (TX) |
| Post Code | 794101813 |
| Phone Number | 8067960202 |
| Fax Number | 8067960496 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA00464 |
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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 |
|---|---|---|---|
| PA00464 | TX | STATE ID NO. | |
| PA00464 | TX | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Holly Jen Tyson by the Centers for Medicare & Medicaid Services?
The Holly Jen Tyson has been issued the NPI (National Provider Identifier) 1699819953. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Holly Jen Tyson's facilities are geographically located?
The facilities of Holly Jen Tyson are physically situated at the following location: 3811 24Th St, Lubbock, TX, 794101813.
What is Holly Jen Tyson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Holly Jen Tyson is Physician Assistant, and the taxonomy classification code that categorizes this area of expertise is 363A00000X.
When was the Holly Jen Tyson's 1699819953 issued?
The Holly Jen Tyson's 1699819953 was issued on 2007-02-19.
As of what date was the information pertaining to Holly Jen Tyson, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Holly Jen Tyson, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2007-07-08.
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