Provider Demographics
NPI:1700803483
Name:VOIGT, ABBY C (PA-C)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:C
Last Name:VOIGT
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 1:900 W MAGNOLIA AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-8517
Mailing Address - Country:US
Mailing Address - Phone:817-921-6166
Mailing Address - Fax:817-921-9594
Practice Address - Street 1:900 W MAGNOLIA AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-8517
Practice Address - Country:US
Practice Address - Phone:817-921-6166
Practice Address - Fax:817-921-9594
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03845363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8D8535Medicare PIN
TXP00642530Medicare PIN
TXTXB111139Medicare PIN
TXQ50438Medicare UPIN