Individual
MRS. NICOLE ALYSE STOCKTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSA
Contact information
Practice address
3418 CARTAGENA DR, CORPUS CHRISTI, TX 78418-3923
(361) 793-9044
Mailing address
3418 CARTAGENA DR, CORPUS CHRISTI, TX 78418-3923
(361) 793-9044
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
SA00646
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163880
THE NATIONAL BOARD OF ST & SA
TX
01
—
671743
TEXAS MEDICAL BOARD - LSA
TX
01
—
SA00646
TEXAS MEDICAL BOARD - LSA
TX
Enumeration date
01/05/2016
Last updated
05/02/2022
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