Basic Information
| Provider Information | |||||||||
| NPI: | 1487306858 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARTIS | ||||||||
| FirstName: | MORGAN | ||||||||
| MiddleName: | ALEXIS | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PA-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ALTIERI | ||||||||
| OtherFirstName: | MORGAN | ||||||||
| OtherMiddleName: | ALEXIS | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 391 SALADA DR | ||||||||
| Address2: | |||||||||
| City: | PROSPER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750780325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2144369012 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6020 W PARKER RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750938172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9726085000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2022 | ||||||||
| LastUpdateDate: | 01/26/2022 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA15346 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.