Provider Demographics
NPI:1356628739
Name:GOUIN, ALISON NICOLE PULEC (PA-C)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:NICOLE PULEC
Last Name:GOUIN
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 1:6601 PRESTON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2502
Mailing Address - Country:US
Mailing Address - Phone:469-800-6300
Mailing Address - Fax:469-800-6351
Practice Address - Street 1:6601 PRESTON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2502
Practice Address - Country:US
Practice Address - Phone:469-800-6300
Practice Address - Fax:469-800-6351
Is Sole Proprietor?:No
Enumeration Date:2011-11-13
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA07536OtherTX PA LICENSE
TXPA07536OtherMEDICAL LICENSE