Individual provider Active NPI

Victoria Palin Wu, PA-C

  • Physician Assistant
  • Jbsa Randolph, TX
National Provider Identifier
1457634982
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
221 3Rd St W BLDG 1040
Jbsa Randolph, TX 78150
Phone
(512) 659-0228
NPI assigned
Sep 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

221 3Rd St W BLDG 1040
Jbsa Randolph, TX 78150

Mailing address

221 3Rd St W BLDG 1040
Jbsa Randolph, TX 78150-4800
Phone (512) 659-0228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150205001911 TX Order and Referring Only - Physician Assistant 2961727367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1457634982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 3RD ST W BLDG 1040",
            "city": "JBSA RANDOLPH",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "512-659-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 3RD ST W BLDG 1040",
            "city": "JBSA RANDOLPH",
            "state": "TX",
            "postal_code": "78150",
            "telephone_number": "512-659-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "VICTORIA",
        "middle_name": "PALIN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Randolph, TX

Sources for this page

Verify at the official NPI Registry.