Healthcare Provider Details

I. General information

NPI: 1912811316
Provider Name (Legal Business Name): JULIA RENAY PURTELL PA-C, MSPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 S STAPLES ST STE 300
CORPUS CHRISTI TX
78411-0002
US

IV. Provider business mailing address

4141 S STAPLES ST ST #300
CORPUS CHRISTI TX
78411-2155
US

V. Phone/Fax

Practice location:
  • Phone: 361-247-4475
  • Fax:
Mailing address:
  • Phone: 361-247-4475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA20971
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: