Healthcare Provider Details

I. General information

NPI: 1912598483
Provider Name (Legal Business Name): ASHLEY SIX PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 09/14/2022
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 W HOLCOMBE BLVD STE 1000
HOUSTON TX
77030-3308
US

IV. Provider business mailing address

1140 BUSINESS CENTER DR STE 202
HOUSTON TX
77043-2741
US

V. Phone/Fax

Practice location:
  • Phone: 713-600-0900
  • Fax: 713-600-0070
Mailing address:
  • Phone: 713-800-0660
  • Fax: 713-827-1380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA13938
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA13938
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA13938
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: