Provider Demographics
NPI:1932797925
Name:DREWS, TAIRA LOUISE (PA-C)
Entity Type:Individual
Prefix:
First Name:TAIRA
Middle Name:LOUISE
Last Name:DREWS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TAIRA
Other - Middle Name:
Other - Last Name:ALDERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 W REYNOSA AVE
Mailing Address - Street 2:
Mailing Address - City:DE LEON
Mailing Address - State:TX
Mailing Address - Zip Code:76444-1630
Mailing Address - Country:US
Mailing Address - Phone:254-893-5895
Mailing Address - Fax:
Practice Address - Street 1:1100 W REYNOSA AVE
Practice Address - Street 2:
Practice Address - City:DE LEON
Practice Address - State:TX
Practice Address - Zip Code:76444-1630
Practice Address - Country:US
Practice Address - Phone:254-893-5895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant