Provider Demographics
NPI:1609389428
Name:NYAGA, ERICK M (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ERICK
Middle Name:M
Last Name:NYAGA
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 OCALA LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-0224
Mailing Address - Country:US
Mailing Address - Phone:413-273-9405
Mailing Address - Fax:
Practice Address - Street 1:3809 OCALA LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-0224
Practice Address - Country:US
Practice Address - Phone:413-273-9405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical