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Individual
ANTHONY ALAN ARVELLO
Active
Individual
ANTHONY ALAN ARVELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02103
TX
363AM0700X
Medical Physician Assistant
PA02103
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1037608
NCCPA CERTIFICATION NUMBER
—
05
—
1841991-04
—
TX
01
—
8888NK
BCBS
TX
01
—
970030289
MEDICARE RAILROAD NUMBER
TX
01
—
PA - 02103
STATE LICENSE NUMBER
TX
Enumeration date
08/30/2006
Last updated
01/26/2018
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