Provider Demographics
NPI:1326310665
Name:WIGINTON, ASHLEY KAY (PA)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:KAY
Last Name:WIGINTON
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:PO BOX 35629
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0629
Mailing Address - Country:US
Mailing Address - Phone:214-424-2200
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:5236 W UNIVERSITY DR
Practice Address - Street 2:SUITE 3300
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7889
Practice Address - Country:US
Practice Address - Phone:972-562-4430
Practice Address - Fax:972-529-2763
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
TXPA07651363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX304305101Medicaid
TXTXB161644Medicare PIN