Provider Demographics
NPI:1518455963
Name:HORTON, CAROLINE (PA)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:SEIFERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18587 SIGMA RD STE 260
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4205
Mailing Address - Country:US
Mailing Address - Phone:210-314-4564
Mailing Address - Fax:210-855-1656
Practice Address - Street 1:18587 SIGMA RD STE 260
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4205
Practice Address - Country:US
Practice Address - Phone:210-314-4564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA11958363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty