Provider Demographics
NPI:1770146615
Name:ENGLE, VICTORIA A (PA-C)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:A
Last Name:ENGLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7501 LAKEVIEW PKWY
Mailing Address - Street 2:STE 245
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-9326
Mailing Address - Country:US
Mailing Address - Phone:469-626-1577
Mailing Address - Fax:469-626-1335
Practice Address - Street 1:7501 LAKEVIEW PKWY STE 245
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-9326
Practice Address - Country:US
Practice Address - Phone:214-227-2457
Practice Address - Fax:214-764-0880
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA14067363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty