Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
May 26, 2026
License(s)
PA20499 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1500 RED RIVER ST | Austin, TX 78701-1918 | 512-324-7000 |
| MAILING | 3118 COUNTY ROAD 172 APT 9209 | Austin, TX 78681-1824 | 405-947-9179 |
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