AMANDA PATTERSON WICKSON (NPI# 1710177464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710177464 |
| Entity Type | Individual |
| Full Name | AMANDA PATTERSON WICKSON |
| Credential | PA-C |
| Practice Address |
808 Keller Pkwy Keller TX 76248-2405 |
| Practice Telephone | 8174312573 |
| Practice Fax Number | 8173796881 |
| Mailing Telephone | 8174312573 |
| Mailing Fax Number | 8173796881 |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2010-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA02797 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
808 KELLER PKWY |
| City | KELLER |
| State | TX |
| Zip Code | 76248-2405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407489347 | Keller Family Medical Center, Pllc | Family Medicine | 808 Keller Pkwy, Keller, TX 76248-2405 | 2020-02-19 |
| 1134593957 | Mallory Lambert | Physician Assistant | 808 Keller Pkwy, Keller, TX 76248-2405 | 2015-11-17 |
| 1982016192 | Christopher Dingess | Family Medicine | 808 Keller Pkwy, Keller, TX 76248-2405 | 2014-05-21 |
| 1023341732 | Shannon Alysha Mccaskey | Nurse Practitioner | 808 Keller Pkwy, Keller, TX 76248-2405 | 2009-09-13 |
| 1841473345 | Bill Burke, Do A Professional Association | Family Medicine | 808 Keller Pkwy, Keller, TX 76248-2405 | 2007-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316556145 | Tyler Woodall | Counselor | 1668 Keller Parkway, Suite 200, Keller, TX 76248 | 2020-07-28 |
| 1396366456 | Kelcie Dao | Speech-Language Pathologist | 630 B Stoneglen Drive, Keller, TX 76248 | 2020-04-29 |
| 1003447384 | Alliance Orthotics and Prosthetics, L.L.C. | Prosthetic/Orthotic Supplier | 101 Bourland Rd Suite A, Keller, TX 76248 | 2020-01-27 |
| 1033759832 | Everest Rehabilitation Hospital Keller, LLC | Rehabilitation Hospital | 955 S. Main St., Keller, TX 76248 | 2020-01-09 |
| 1750934253 | Pediatric Dentistry of Keller Pllc | Dentist | 1627 Keller Parkway, Suite 100, Keller, TX 76248 | 2019-07-23 |
| 1306345293 | Jaqui Otto | Psychologist | 1664 Keller Parkway Ste 102, Keller, TX 76248 | 2018-02-06 |
| 1194223404 | Hartman Samuel Ian Watson | Chiropractor | 1211 S Main St Ste 300h, Keller, TX 76248 | 2018-02-01 |
| 1760900997 | Md First Watch Healthcare Pllc | Clinic/Center | 310 Keller Parkway, Keller, TX 76248 | 2017-09-08 |
| 1588104541 | Elias Alharari | Nurse Practitioner | 651 S Main St Ste 102, Keller, TX 76248 | 2017-02-24 |
| 1730631698 | Alliance Counseling and Education Center | Social Worker | 1540 Keller Parkway, Ste. 108-205, Keller, TX 76248 | 2016-10-26 |
| Find all providers in zip 76248 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053597989 | Dana Lynne Landavazo | Physician Assistant | 10601 N Riverside Dr, Keller, TX 76244-2118 | 2008-01-10 |
| 1912059924 | Nives Chan | Physician Assistant | 8865 Davis Blvd Ste 100a, Keller, TX 76248-0322 | 2007-01-18 |
| 1306304068 | Allison Dimaggio | Physician Assistant | 1141 Keller Pkwy Ste B, Keller, TX 76248-1628 | 2019-03-12 |
| 1912484924 | Saira Bana | Physician Assistant | 720 S Main St, Keller, TX 76248 | 2018-07-23 |
| 1659800449 | Jill Sarah Rowland | Physician Assistant | 240 N Rufe Snow Dr, Keller, TX 76248-4226 | 2017-06-06 |
| 1124563671 | Jessica Marie Zimmer | Physician Assistant | 8739 Davis Blvd, Ste A, Keller, TX 76248-0309 | 2016-12-19 |
| 1134593957 | Mallory Lambert | Physician Assistant | 808 Keller Pkwy, Keller, TX 76248-2405 | 2015-11-17 |
| 1730550013 | Dieu Linh Thi Nguyen | Physician Assistant | 720 S Main St, Keller, TX 76248-4936 | 2015-10-13 |
| 1306237805 | Erin Nicole Herrmann | Physician Assistant | 651 S Main St, Suite 105, Keller, TX 76248-7038 | 2015-02-05 |
| 1821405432 | Megan Munday Perkins | Physician Assistant | 720 S Main St, Keller, TX 76248-4936 | 2014-07-15 |
| Find all providers in KELLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.