Individual provider Active NPI

Angela Nolen, P.A.-C.

  • Physician Assistant
  • New Braunfels, TX
National Provider Identifier
1730361635
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05474 Issued in TX
Practice address
921 Lakeview Blvd
New Braunfels, TX 78130-4135
Phone
(830) 625-3999
NPI assigned
Dec 3, 2007
Last updated
Jan 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA05474 TX Primary

Addresses

Primary practice location

921 Lakeview Blvd
New Braunfels, TX 78130-4135

Mailing address

921 Lakeview Blvd
New Braunfels, TX 78130-4135
Phone (830) 625-3999

Other identifiers 3

IdentifierTypeStateIssuer
282224901MedicaidTX
282111801MedicaidTX
282111802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA05474TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Track Urgent Care - Bastrop Physician Assistant CurrentSince Mar 21, 2015 Accepting new patients
St. David's Carenow Urgent Care PLLC Past Accepting new patients

Locations

17910 Bulverde Rd
Ste 115
San Antonio, TX 78259
Phone (210) 906-8478

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1730361635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 LAKEVIEW BLVD",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781304135",
            "telephone_number": "830-625-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 LAKEVIEW BLVD",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781304135",
            "telephone_number": "830-625-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLEN",
        "first_name": "ANGELA",
        "name_prefix": "Ms.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282224901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282111801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282111802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Braunfels, TX

Sources for this page

Verify at the official NPI Registry.