Individual provider · Type 1 NPI

Daniel Zackary Souvannarath

Physician Assistant · Bridgeton, MO

NPI number 1174144828 Active

Practice location

12266 De Paul Dr Ste 310
Bridgeton, MO 63044-2562

Call (314) 209-5171 Map

Mailing address

PO Box 955534
St. Louis, MO 63195-5534

Other practice locations

  • 3437 Caroline St Ste 3082, St. Louis, MO 63104-1111 · (314) 977-8648

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Physician Assistant Primary 363A00000X2021010216 (MO)

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, orde…

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About NPI 1174144828

Daniel Zackary Souvannarath's National Provider Identifier is 1174144828, issued on May 5, 2020. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Bridgeton, MO. The record was last updated on Sep 13, 2021.