Pierce McKinnon Neitzke, PA-C
Physician Assistant, Medical in Austin, TX. Individual provider (NPI-1).
NPI number1982102430
StatusActive
Last updated in NPPESApr 6, 2023
Details
- NPI
- 1982102430
- Entity type
- Individual (NPI-1)
- Name
- Pierce McKinnon Neitzke
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 30, 2018
- Certification date
- Apr 6, 2023
- Last updated
- Apr 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA15785 | TX | Yes |
| 363A00000X | Physician Assistant | 0010-07905 | NC | |
| 363AS0400X | Physician Assistant, Surgical | 0010-07905 | NC |
Practice location
2525 Wallingwood Dr Ste 200Austin, TX 78746-6937
Phone 512-744-5489
Mailing address
2525 Wallingwood Dr Ste 200Austin, TX 78746-6937
Phone 512-744-5489
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