Provider Demographics
NPI:1649897455
Name:DOUGAN, ZORYANA (PA-C)
Entity type:Individual
Prefix:
First Name:ZORYANA
Middle Name:
Last Name:DOUGAN
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 1:8818 TRAVIS HILLS DR APT 620
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-1783
Mailing Address - Country:US
Mailing Address - Phone:201-394-2280
Mailing Address - Fax:
Practice Address - Street 1:8818 TRAVIS HILLS DR APT 620
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-1783
Practice Address - Country:US
Practice Address - Phone:201-394-2280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-26
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13923363A00000X, 363AM0700X, 363AS0400X
CAPA58269363AM0700X, 363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical