Provider Demographics
NPI:1558789966
Name:ELLIOTT, JILL ASHLEY (PA-C)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:ASHLEY
Last Name:ELLIOTT
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 1:13830 SAWYER RANCH RD
Mailing Address - Street 2:STE 102
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-5514
Mailing Address - Country:US
Mailing Address - Phone:512-301-6400
Mailing Address - Fax:512-301-6401
Practice Address - Street 1:228 SAINT GEORGE ST
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:TX
Practice Address - Zip Code:78629-3910
Practice Address - Country:US
Practice Address - Phone:830-672-6511
Practice Address - Fax:830-672-6430
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09067363AM0700X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant