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General NPI Number Information
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NPI Number | 1811137730
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Entity Type | Organization
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Legal Business Name | PHYSICIAN ASSISTANT UNLIMITED, PC
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 9311 LLANO VERDE
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City | HELOTES
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State | TX
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Zip | 78023
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Country | US
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Telephone | 210-379-2236
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Fax |
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Provider Business Mailing Address
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Address Line | 9311 LLANO VERDE
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City | HELOTES
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State | TX
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Zip | 78023
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Country | US
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Telephone | 210-379-2236
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. MATTHEW A FROMAN
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Credential | PA-C
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Telephone | 210-379-2236
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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 | PA03548
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License Number State | TX
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