Basic Information
| Provider Information | |||||||||
| NPI: | 1386690568 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KARSKY | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 310 W OAKLAWN RD | ||||||||
| Address2: | |||||||||
| City: | PLEASANTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 780644033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8305698940 | ||||||||
| FaxNumber: | 8605698320 | ||||||||
| Practice Location | |||||||||
| Address1: | 203 HACKBERRY ST | ||||||||
| Address2: | |||||||||
| City: | TILDEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3612743690 | ||||||||
| FaxNumber: | 3612743760 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 09/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | PA08094 | 01 | TX | LICENSE | OTHER |