Provider Demographics
NPI:1417270315
Name:ADAMS, KAREN A (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:A
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:A
Other - Last Name:LYONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:326 W CRAIG PLACE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-3307
Mailing Address - Country:US
Mailing Address - Phone:210-692-3000
Mailing Address - Fax:210-692-3056
Practice Address - Street 1:18707 HARDY OAK BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4794
Practice Address - Country:US
Practice Address - Phone:210-370-9995
Practice Address - Fax:210-370-9994
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-05
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06621207N00000X, 363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB117596Medicare PIN