Provider Demographics
NPI:1912680372
Name:VERSNEL, ERIANNA LEIGH (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIANNA
Middle Name:LEIGH
Last Name:VERSNEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERIANNA
Other - Middle Name:LEIGH
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5312 INKER ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-3141
Mailing Address - Country:US
Mailing Address - Phone:210-875-7791
Mailing Address - Fax:
Practice Address - Street 1:931 YALE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-6919
Practice Address - Country:US
Practice Address - Phone:346-888-3930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX772078363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical