MR. VIRGUST JUSTICE DYKES (NPI# 1386067304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386067304 |
| Entity Type | Individual |
| Full Name | MR. VIRGUST JUSTICE DYKES |
| Credential | P.A. |
| Practice Address |
668 W Brazos Ave West Columbia TX 77486-2616 |
| Mailing Address |
2600 Fm 1764 Rd Ste 190 La Marque TX 77568-2826 |
| Practice Telephone | 9793452525 |
| Mailing Telephone | 2818868964 |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2017-07-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA08778 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA08778 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
668 W BRAZOS AVE |
| City | WEST COLUMBIA |
| State | TX |
| Zip Code | 77486-2616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922349174 | Falon Leshay Turner | Nurse Practitioner | 668 W Brazos Ave, West Columbia, TX 77486-2616 | 2013-03-13 |
| 1598178998 | Lisa Marie Schaubroeck | Nurse Practitioner | 668 W Brazos Ave, West Columbia, TX 77486-2616 | 2014-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982969242 | Laura K. Kincannon | Dentist | 907 S. Columbia Dr., West Columbia, TX 77486 | 2012-07-11 |
| 1437310323 | Walgreen Co. | Pharmacy | 100 E Brazos Ave, West Columbia, TX 77486 | 2008-06-23 |
| 1821160409 | Terry L Driggers | Dentist | 505 Dance Drive, West Columbia, TX 77486 | 2006-11-15 |
| 1568560142 | Robert L. Coburn, D.c.,p.c. | Chiropractor | 211 N Columbia Dr, West Columbia, TX 77486-2518 | 2006-09-20 |
| 1700078995 | Robert Lee Coburn | Chiropractor | 211 N Columbia Dr, West Columbia, TX 77486-2518 | 2007-08-13 |
| 1922025105 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 301 N Columbia Dr, West Columbia, TX 77486-2520 | 2006-07-16 |
| 1528617883 | Ndidi Godfrey | Pharmacist | 301 N Columbia Dr, West Columbia, TX 77486-2520 | 2019-09-10 |
| 1326527268 | Angela Elizabeth Hughes | Pharmacy | 301 N Columbia Dr, West Columbia, TX 77486-2520 | 2018-08-10 |
| 1144686262 | Boyang Lin | Pharmacist | 301 N Columbia Dr, West Columbia, TX 77486-2520 | 2016-01-05 |
| 1770081028 | Sweeny Hospital District | Clinic/Center | 668 W Brazos Ave Ste 668, West Columbia, TX 77486-2616 | 2018-01-31 |
| Find all providers in zip 77486 | ||||
| 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 |
|---|---|---|---|---|
| 1134418270 | Laura Ann Rate | Physician Assistant | 146 E Hospital Dr Ste 140, West Columbia, SC 29169-4800 | 2011-03-29 |
| 1578676417 | Sabrina Phillips Garrison | Physician Assistant | 513 S Columbia Dr, West Columbia, TX 77486-3025 | 2006-08-16 |
| 1730188517 | Jennifer G D'antoni | Physician Assistant | 3231 Sunset Blvd, Suite C, West Columbia, SC 29169-3483 | 2005-07-14 |
| 1609485333 | Gerardo A Santiago Jr. | Physician Assistant | 110 Medical Cir, West Columbia, SC 29169-3642 | 2020-07-28 |
| 1205480803 | Shelley S Crawford | Physician Assistant | 2720 Sunset Blvd, West Columbia, SC 29169-4810 | 2019-07-31 |
| 1962900357 | Andre Johnathan Kennedy | Physician Assistant | 111 W Hospital Dr, West Columbia, SC 29169-3405 | 2018-01-31 |
| 1477098192 | Eric T Holberton | Physician Assistant | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2017-01-04 |
| 1346794732 | Gary Alan Benda Jr. | Physician Assistant | 222 E Medical Ln Ste 100&200, West Columbia, SC 29169-4847 | 2016-08-15 |
| 1790148823 | Morgan Mixon Armstrong | Physician Assistant | 3314 Platt Springs Rd, West Columbia, SC 29170-2204 | 2016-04-05 |
| 1033589080 | Mallory Parker | Physician Assistant | 2720 Sunset Blvd, West Columbia, SC 29169-4810 | 2015-10-03 |
| Find all providers in WEST COLUMBIA | ||||
| City | WEST COLUMBIA |
| Zip Code | 77486 |
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| 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.