Provider Demographics
NPI:1770693228
Name:STRAPP, JUDITH ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:ELIZABETH
Last Name:STRAPP
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 1:601 RIVER POINTE DRIVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304
Mailing Address - Country:US
Mailing Address - Phone:936-788-6060
Mailing Address - Fax:936-788-6061
Practice Address - Street 1:601 RIVER POINTE DRIVE
Practice Address - Street 2:SUITE 120
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304
Practice Address - Country:US
Practice Address - Phone:936-788-6060
Practice Address - Fax:936-788-6061
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02312363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
8J2387Medicare UPIN