Hartzog, Ashley D

Hartzog, Ashley D is an individual health care provider with primary practice located at 3061 W Southlake Blvd Ste 130 , Southlake TX 76092-0314. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Hartzog, Ashley D can be contacted via phone (817) 928-3335.

Contact Information

Primary practice address
3061 W Southlake Blvd Ste 130 Southlake TX 76092-0314
Phone: (817) 928-3335
Fax: (817) 928-3169
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA04640 Texas

Profile Details

NPI number 1184643868
LBN Legal business name Hartzog, Ashley D
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Apr 19th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184643868 NPPES
Texas MEDICAID 182906101
Texas MEDICAID 182906106

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