Provider Demographics
NPI:1043537566
Name:LYNCH, ALISON (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 HALL JOHNSON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-8766
Mailing Address - Country:US
Mailing Address - Phone:817-267-2678
Mailing Address - Fax:817-354-0854
Practice Address - Street 1:2050 HALL JOHNSON RD STE 200
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-8766
Practice Address - Country:US
Practice Address - Phone:817-267-2678
Practice Address - Fax:817-354-0854
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06584363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant