Provider Demographics
NPI:1275185977
Name:ALARCON, ANGELA (PA -C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:ALARCON
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 1:5406 MIDDLE FISKVILLE RD APT 206
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-1414
Mailing Address - Country:US
Mailing Address - Phone:832-248-3190
Mailing Address - Fax:
Practice Address - Street 1:1101 W 40TH ST STE 102
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3609
Practice Address - Country:US
Practice Address - Phone:512-853-9547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12874363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant