Provider Demographics
NPI:1851324917
Name:STYLES, ANGELA D (PAC)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:D
Last Name:STYLES
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9261
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-9261
Mailing Address - Country:US
Mailing Address - Phone:940-764-5400
Mailing Address - Fax:940-764-5454
Practice Address - Street 1:1620 8TH STREET
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301
Practice Address - Country:US
Practice Address - Phone:940-764-5400
Practice Address - Fax:940-764-5454
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10004998363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAQ66489Medicare UPIN
WA8859338Medicare ID - Type Unspecified