Provider Demographics
NPI:1902350192
Name:TROXELL, ELIZABETH C (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:TROXELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:CLAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:612 E BAILEY BOSWELL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:TX
Mailing Address - Zip Code:76131-3571
Mailing Address - Country:US
Mailing Address - Phone:817-232-1343
Mailing Address - Fax:817-232-3397
Practice Address - Street 1:612 E BAILEY BOSWELL RD STE 200
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76131-3571
Practice Address - Country:US
Practice Address - Phone:817-232-1343
Practice Address - Fax:817-232-3397
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10671363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX531473YKPWMedicare PIN