Provider Demographics
NPI:1225034796
Name:VIOLA, VINCE (PA-C)
Entity Type:Individual
Prefix:
First Name:VINCE
Middle Name:
Last Name:VIOLA
Suffix:
Gender:M
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 1:4545 HARTFORD ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-4602
Mailing Address - Country:US
Mailing Address - Phone:325-698-4545
Mailing Address - Fax:325-698-4547
Practice Address - Street 1:4351 RIDGEMONT DR STE A
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-8747
Practice Address - Country:US
Practice Address - Phone:254-245-9175
Practice Address - Fax:254-213-7771
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2023-09-12
Deactivation Date:2006-06-14
Deactivation Code:
Reactivation Date:2007-01-31
Provider Licenses
StateLicense IDTaxonomies
TXPA01177363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120045101OtherFIRSTCARE
TX8V4080OtherBCBS
TX1723395OtherFIRST HEALTH
TX4200747OtherBLUE LINK
TX8L25859Medicare PIN
TX1723395OtherFIRST HEALTH
TXR59746Medicare UPIN