Provider Demographics
NPI:1811137730
Name:PHYSICIAN ASSISTANT UNLIMITED, PC
Entity type:Organization
Organization Name:PHYSICIAN ASSISTANT UNLIMITED, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:FROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:210-379-2236
Mailing Address - Street 1:9311 LLANO VERDE
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023
Mailing Address - Country:US
Mailing Address - Phone:210-379-2236
Mailing Address - Fax:
Practice Address - Street 1:9311 LLANO VERDE
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023
Practice Address - Country:US
Practice Address - Phone:210-379-2236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03548363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty