| Tiffany Kay Wilson, PA | |
|
412 W South St, Henrietta, TX 76365-3348 | |
| (940) 235-3403 | |
| (580) 272-0186 |
| Full Name | Tiffany Kay Wilson |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 23 Years |
| Location | 412 W South St, Henrietta, Texas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710920178 | NPI | - | NPPES |
| 185065301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 2381 (Oklahoma) | Secondary |
| 363A00000X | Physician Assistant | PA04018 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Parkview Hospital Home Health Agency | Wheeler, TX | Home health agency |
| Shamrock General Hospital | Shamrock, TX | Hospital |
| Parkview Hospital | Wheeler, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Preferred Hospital Leasing Shamrock Inc | 9739577578 | 3 |
| Mailing Address | Practice Location Address |
|---|---|
| Tiffany Kay Wilson, PA 412 W South St, Henrietta, TX 76365-3348 Ph: (940) 235-3403 | Tiffany Kay Wilson, PA 412 W South St, Henrietta, TX 76365-3348 Ph: (940) 235-3403 |
Mr. Thomas Wayne Distel, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 102 S Archer St, Henrietta, TX 76365 Phone: 940-538-4336 Fax: 940-538-6271 |