Provider Demographics
NPI:1477560688
Name:WALL, FLORENCE E (PA-C)
Entity Type:Individual
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First Name:FLORENCE
Middle Name:E
Last Name:WALL
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:MC7977
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-9000
Mailing Address - Fax:
Practice Address - Street 1:8300 FLOYD CURL DR
Practice Address - Street 2:3RD FL - 3C
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3931
Practice Address - Country:US
Practice Address - Phone:210-450-9300
Practice Address - Fax:210-450-6023
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2013-06-12
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Provider Licenses
StateLicense IDTaxonomies
TXPA02514363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant