Provider Demographics
NPI:1255302782
Name:SKAGGS, STEVEN ANTHONY (PA-C)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ANTHONY
Last Name:SKAGGS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9515 LINDEN AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3232
Mailing Address - Country:US
Mailing Address - Phone:206-217-9449
Mailing Address - Fax:206-217-6636
Practice Address - Street 1:7703 FLOYD CURL DRIVE - MC 6249
Practice Address - Street 2:UT HEALTH SCIENCE CENTER SAN ANTONIO
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-567-4244
Practice Address - Fax:210-567-4241
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA05254363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX385196601Medicaid