Basic Information
| Provider Information | |||||||||
| NPI: | 1679699375 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIMPSON | ||||||||
| FirstName: | ASHLEY | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8109 FREDERICKSBURG RD | ||||||||
| Address2: | PHYSICIAN PRACTICE SERVICES | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105753817 | ||||||||
| FaxNumber: | 2105754113 | ||||||||
| Practice Location | |||||||||
| Address1: | 7700 FLOYD CURL DR | ||||||||
| Address2: | 10TH FLOOR | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105753817 | ||||||||
| FaxNumber: | 2105754113 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2007 | ||||||||
| LastUpdateDate: | 11/05/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA03477 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 849N53 | 01 | TX | BCBS | OTHER | 220169101 | 05 | TX | MEDICAID | 220169102 | 01 | TX | MEDICAID CSHCN | OTHER |