Provider Demographics
NPI:1700331436
Name:FLUITT, MARKAY WILSON (PA-C)
Entity Type:Individual
Prefix:
First Name:MARKAY
Middle Name:WILSON
Last Name:FLUITT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19026 RIDGEWOOD PKWY STE 311
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-5502
Mailing Address - Country:US
Mailing Address - Phone:833-304-1589
Mailing Address - Fax:830-816-6922
Practice Address - Street 1:5330 N LOOP 1604 W STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-4384
Practice Address - Country:US
Practice Address - Phone:210-469-3830
Practice Address - Fax:830-219-8045
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA11305363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant