Individual
MRS. ELISE CHURCHILL APPLEGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1700 UNIVERSITY DR E, COLLEGE STATION, TX 77840-2661
(979) 691-3300
(979) 691-3527
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA08244
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341236301
—
TX
01
—
8173NN
BCBS
TX
Enumeration date
04/05/2013
Last updated
02/14/2022
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