Active NPI
Elizabeth Wyckoff, CST, CSFA
- Surgical Assistant
- Van Alstyne, TX
National Provider Identifier
1316612203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 198355
- Practice address
- 1308 S Waco St
Van Alstyne, TX 75495-2641 - Phone
- (214) 264-6700
- NPI assigned
- Aug 12, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | |||
| Surgical Assistant | 246ZC0007X | 198355 | TX | Primary |
Addresses
Primary practice location
1308 S Waco St
Van Alstyne, TX 75495-2641
Mailing address
PO Box 2550
Rowlett, TX 75030-2550
Phone (214) 227-2457
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 198355 | TX | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631750400000",
"number": "1316612203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2550",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750302550",
"telephone_number": "214-227-2457",
"fax_number": "214-764-0880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1308 S WACO ST",
"city": "VAN ALSTYNE",
"state": "TX",
"postal_code": "754952641",
"telephone_number": "214-264-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYCKOFF",
"first_name": "ELIZABETH",
"credential": "CST, CSFA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-12",
"last_updated": "2021-09-16",
"certification_date": "2021-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "TX",
"license": "198355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Alstyne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.