Provider Demographics
NPI:1164071684
Name:PYE, JULIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:
Last Name:PYE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:GRIENITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1601 MONTE VISTA AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-6604
Mailing Address - Country:US
Mailing Address - Phone:909-865-9501
Mailing Address - Fax:
Practice Address - Street 1:810 E. RALPH HALL PRKWY
Practice Address - Street 2:SUITE #100
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032
Practice Address - Country:US
Practice Address - Phone:469-402-3400
Practice Address - Fax:909-630-7869
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-06
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA14353363A00000X
CAPA57260363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant