Provider Demographics
NPI:1073212650
Name:ATNIP, ALEXANDRA MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MARIE
Last Name:ATNIP
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8300 N LAMAR BLVD STE 200A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-5976
Mailing Address - Country:US
Mailing Address - Phone:888-201-5112
Mailing Address - Fax:512-782-9316
Practice Address - Street 1:8300 N LAMAR BLVD STE 200A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-5976
Practice Address - Country:US
Practice Address - Phone:888-201-5112
Practice Address - Fax:512-782-9316
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16605207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine