Provider Demographics
NPI:1235229212
Name:TRIGG, SUSAN L (PA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:TRIGG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7460 WARREN PKWY
Mailing Address - Street 2:SUITE 160
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4169
Mailing Address - Country:US
Mailing Address - Phone:972-668-5400
Mailing Address - Fax:972-668-5401
Practice Address - Street 1:7460 WARREN PKWY
Practice Address - Street 2:SUITE 160
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4169
Practice Address - Country:US
Practice Address - Phone:972-668-5400
Practice Address - Fax:972-668-5401
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04155363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA04155OtherPHYSICIAN ASSISTANT PERMI
TX8D1679Medicare ID - Type Unspecified
TXPA04155OtherPHYSICIAN ASSISTANT PERMI
TX273226YNVLMedicare PIN