Provider Demographics
NPI:1124117262
Name:ALBRIGHT, AUGUSTINA ATSOI (PA)
Entity type:Individual
Prefix:
First Name:AUGUSTINA
Middle Name:ATSOI
Last Name:ALBRIGHT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3537 S I 35 E STE 308
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6870
Mailing Address - Country:US
Mailing Address - Phone:940-382-2204
Mailing Address - Fax:940-382-2204
Practice Address - Street 1:2535 IRA E WOODS AVE
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051
Practice Address - Country:US
Practice Address - Phone:817-481-2121
Practice Address - Fax:817-488-4493
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2018-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA03329363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP78443Medicare UPIN
TX8C0765Medicare PIN