Individual
AGATHA RAE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
800 MEDICAL CENTER DR STE C, DECATUR, TX 76234-3844
(940) 626-2110
(940) 626-2113
Mailing address
800 MEDICAL CENTER DR STE C, DECATUR, TX 76234-3844
(406) 262-1109
(940) 626-2113
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05810
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
319647902
—
TX
01
—
8N0426
BCBSTX
TX
Enumeration date
06/27/2008
Last updated
07/21/2021
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