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NPI Code Detail

MEDICARE: MR. BRIAN WOODS INGRAM PA-C

MEDICARE: MR. BRIAN WOODS INGRAM PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA09810TX
2363A00000XPhysician AssistantPA2016-0054NM

General Provider Information

NPI Number : 1811380611
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN WOODS INGRAM PA-C
Provider Business Mailing Address
First Line : 1109 W NOLANA AVE STE 101
Second Line :
City : MCALLEN
State : TX
Zip : 78504-3794
Country : US
Telephone Number : 956-688-8023
Fax Number : 844-224-6329
Provider Business Practice Location Address
First Line : 1109 W NOLANA AVE STE 101
Second Line :
City : MCALLEN
State : TX
Zip : 78504-3794
Country : US
Telephone Number : 956-688-8023
Fax Number : 844-224-6329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2015
Last Update Date : 09/26/2025

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