Provider Demographics
NPI:1447207246
Name:SKILLINS, BETH M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:M
Last Name:SKILLINS
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 1:8945 LONG POINT RD
Mailing Address - Street 2:212
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-3034
Mailing Address - Country:US
Mailing Address - Phone:713-464-7212
Mailing Address - Fax:
Practice Address - Street 1:8945 LONG POINT RD
Practice Address - Street 2:212
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3034
Practice Address - Country:US
Practice Address - Phone:713-464-7212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03790363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX828013194OtherMEDICARE RAILROAD
TX828013194OtherMEDICARE RAILROAD
TXQ10031Medicare UPIN