NPIMap

Organization Active NPI

Concho Physician Assistant Placement Services

  • Surgical Physician Assistant
  • San Angelo, TX
National Provider Identifier
1649568411
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA05955 Issued in TX
Legal business name
CONCHO PHYSICIAN ASSISTANT PLACEMENT SERVICES
Practice address
1633 Parkview Dr
San Angelo, TX 76904-6848
Phone
(325) 226-3503
NPI assigned
Jul 14, 2011
Last updated
Jul 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Authorized official

Name
Bethany Wood
Title
Manager
Phone
(325) 226-3503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363AS0400X PA05955 TX Primary

Addresses

Primary practice location

1633 Parkview Dr
San Angelo, TX 76904-6848

Mailing address

PO Box 4026
San Angelo, TX 76902-4026
Phone (325) 226-3503

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1649568411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4026",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769024026",
            "telephone_number": "325-226-3503",
            "fax_number": "325-617-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 PARKVIEW DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046848",
            "telephone_number": "325-226-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCHO PHYSICIAN ASSISTANT PLACEMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "325-226-3503"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA05955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.