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General NPI Number Information
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NPI Number | 1396306403
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Entity Type | Organization
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Legal Business Name | PHYSICIAN ASSISTANTS OF TEXAS PLLC
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Dates
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Enumeration Date | 06/28/2019
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 1901 MILLER RD
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City | ROWLETT
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State | TX
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Zip | 75088-5604
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Country | US
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Telephone | 214-227-2457
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Fax |
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Provider Business Mailing Address
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Address Line | 2963 N SUNBECK CIR
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City | FARMERS BRANCH
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State | TX
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Zip | 75234-7415
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Country | US
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Telephone | 469-878-1321
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAMELA GAMBLE
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Credential | PA-C
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Telephone | 469-878-1321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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