Provider Demographics
NPI:1225748544
Name:LANDRY, ABBIE (PA-C)
Entity Type:Individual
Prefix:
First Name:ABBIE
Middle Name:
Last Name:LANDRY
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 1:1601 STONEOAK DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-8732
Mailing Address - Country:US
Mailing Address - Phone:214-578-9344
Mailing Address - Fax:
Practice Address - Street 1:8880 STATE HIGHWAY 121 STE 118
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3132
Practice Address - Country:US
Practice Address - Phone:469-342-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16274363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant