Individual
ASHLEY D HARTZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3061 W SOUTHLAKE BLVD STE 130, SOUTHLAKE, TX 76092-0314
(817) 928-3335
(817) 928-3169
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 378-3699
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04640
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182906101
—
TX
05
—
182906106
—
TX
Enumeration date
07/19/2006
Last updated
04/19/2023
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