Phillip Steven Woessner, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA11722 Issued in TX

Practice address

1325 Pennsylvania Ave Ste 890
Fort Worth, TX 76104-2145

Phone

(817) 250-4280

Fax

(817) 250-4281

NPI assigned

Jun 5, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1003177262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE STE 890",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042145",
            "telephone_number": "817-250-4280",
            "fax_number": "817-250-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE STE 890",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042145",
            "telephone_number": "817-250-4280",
            "fax_number": "817-250-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOESSNER",
        "first_name": "PHILLIP",
        "middle_name": "STEVEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-05",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA11722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Witulski, FNP
• Heather Witzke, LCSW
• Kurtt R Wix, DO
• Woerner Physical Therapy LLC
• Marie Breithaupt Woerner, PT, DPT, WCS, CLT
• Daina Wofford
• Ogechi Wogugu, PHARM.D.
• Vivian Woh
• Amday Wolde, MD
• Kristal L Woldu, M.D.

• Surgical Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.