Provider Demographics
NPI:1588338602
Name:TREE, TEEGAN MICHAIAH (PA-C)
Entity type:Individual
Prefix:MISS
First Name:TEEGAN
Middle Name:MICHAIAH
Last Name:TREE
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:TEEGAN
Other - Middle Name:MICHAIAH
Other - Last Name:LUCKEMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1581 FLAMING OAK DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-4173
Mailing Address - Country:US
Mailing Address - Phone:830-237-6690
Mailing Address - Fax:
Practice Address - Street 1:479 OXFORD DR STE 1041330
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-7422
Practice Address - Country:US
Practice Address - Phone:830-625-3481
Practice Address - Fax:830-609-1997
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA14682363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant