Provider Demographics
NPI:1962437806
Name:SETTLES, LARRY J (PA)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:J
Last Name:SETTLES
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1108 GULF FWY S
Mailing Address - Street 2:STE 230
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-5100
Mailing Address - Country:US
Mailing Address - Phone:409-370-9587
Mailing Address - Fax:281-557-4443
Practice Address - Street 1:1108 GULF FWY S
Practice Address - Street 2:STE 230
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-5100
Practice Address - Country:US
Practice Address - Phone:409-370-9587
Practice Address - Fax:281-557-4443
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA03741363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8N8368OtherBCBS
TX182256101Medicaid
TX182256101Medicaid
TX8N8368OtherBCBS