MISS BONNIE BETH WICKHAM (NPI# 1225058902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225058902 |
| Entity Type | Individual |
| Full Name | MISS BONNIE BETH WICKHAM |
| Credential | PA |
| Practice Address |
402 W 26th St San Angelo TX 76903-2826 |
| Mailing Address |
Po Box 22000 San Angelo TX 76902-7200 |
| Practice Telephone | 3256581511 |
| Practice Fax Number | 3254812166 |
| Mailing Telephone | 3256581511 |
| Mailing Fax Number | 3254812104 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2016-08-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA04799 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
402 W 26TH ST |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76903-2826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679013585 | Paige Linsey Anderson | Nurse Practitioner | 402 W 26th St, San Angelo, TX 76903-2826 | 2017-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306386081 | The Waterford Wellness Spa | Clinic/Center | 602 S. Abe, San Angelo, TX 76903 | 2017-03-01 |
| 1154782415 | Jerrica Elayne Escobedo | Counselor | 424 South Oakes, San Angelo, TX 76903 | 2016-03-15 |
| 1578923868 | Wal-mart Stores Texas, LLC | Technician/Technologist | 3440 S. Bryant Blvd, San Angelo, TX 76903 | 2016-02-29 |
| 1821475161 | San Angelo Dental, Pllc | Dentist | 614 29th Street, Suite, Sanangelo, TX 76903 | 2015-05-06 |
| 1033549670 | Tina Faye Luck | Nurse Practitioner | 36 E Twohig Ave Ste 1100, San Angelo, TX 76903 | 2013-11-18 |
| 1295087294 | Tara Joiner | Counselor | 27 W Beauregard Ave, San Angelo, TX 76903 | 2012-10-15 |
| 1225380728 | Tanya L Favor | Physician Assistant | 215 E. College, San Angelo, TX 76903 | 2012-10-08 |
| 1336459551 | Education Service Center | Social Worker | 612 S Irene, San Angelo, TX 76903 | 2010-10-21 |
| 1508194176 | Pay and Save Inc | Pharmacy | 1926 N. Bryant Blvd., San Angelo, TX 76903 | 2009-11-19 |
| 1326375734 | Pay and Save Inc | Pharmacy | 2 S. Main St., San Angelo, TX 76903 | 2009-11-05 |
| Find all providers in zip 76903 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548827678 | Sds Practice Solutions LLC | Physician Assistant | 17 S Chadbourne St Ste 301, San Angelo, TX 76903-5864 | 2019-05-23 |
| 1700398484 | Jacob Webster | Physician Assistant | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2017-11-02 |
| 1912306028 | Garrett Herdman | Physician Assistant | 2626 N Bryant Blvd, San Angelo, TX 76903-2861 | 2014-08-14 |
| 1275954232 | Michael Matthews | Physician Assistant | 3605 Executive Dr, San Angelo, TX 76904-6884 | 2013-12-18 |
| 1447681903 | Mary Studt | Physician Assistant | 2626 N Bryant Blvd, San Angelo, TX 76903-2861 | 2013-12-10 |
| 1588009807 | San Angelo Emergency Medicine Associates Pa | Physician Assistant | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2013-04-30 |
| 1457606154 | Oasis of West Tx Emergency | Physician Assistant | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2012-07-18 |
| 1619231511 | Jumano Emergency Physicians | Physician Assistant | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2012-06-26 |
| 1326324757 | Leslie D Jansa | Physician Assistant | 4450 Sunset Dr, San Angelo, TX 76901-5611 | 2011-10-31 |
| 1891070991 | Alex Hughes II | Physician Assistant | 271 Fort Richardson Ave, San Angelo, TX 76908-4901 | 2011-10-20 |
| Find all providers in SAN ANGELO | ||||
| City | SAN ANGELO |
| Zip Code | 76903 |
Please comment or provide details below to improve the information on MISS BONNIE BETH WICKHAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.