Organization
GATOR PA 1ST ASSIST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA ANN AHMED PA-C (OWNER)
(972) 814-6341
Entity
Organization
Contact information
Practice address
10900 STONELAKE BLVD STE A-320, AUSTIN, TX 78759-5833
(866) 698-0052
Mailing address
10900 STONELAKE BLVD STE A-320, AUSTIN, TX 78759-5833
(866) 698-0052
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA01673
TX
Other
Enumeration date
12/19/2012
Last updated
12/19/2012
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