Individual
MRS. ASHTON MARIE UNDERBRINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, HOUSTON, TX 77210-4439
(713) 792-6161
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07741
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297116001
—
TX
01
—
8N0375
BCBS
TX
Enumeration date
05/29/2012
Last updated
08/15/2012
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