Provider Demographics
NPI:1609838325
Name:SCHRANK, KEVIN ALEXANDER (PA-C)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:ALEXANDER
Last Name:SCHRANK
Suffix:
Gender:M
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 1:15822 FOOTHILL FARMS LOOP
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3422
Mailing Address - Country:US
Mailing Address - Phone:512-978-9840
Mailing Address - Fax:512-901-9770
Practice Address - Street 1:15822 FOOTHILL FARMS LOOP
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3422
Practice Address - Country:US
Practice Address - Phone:512-978-9840
Practice Address - Fax:512-901-9770
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04807363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ69786Medicare UPIN
TX8G5903Medicare PIN