Individual provider · Type 1 NPI

Dallas Carranza, PA

Medical Physician Assistant · Fort Leonard Wood, MO

NPI number 1699401919 Active

Practice location

4234 Illinois Ave
Fort Leonard Wood, MO 65473-9098

Call (573) 596-4178 Map

Mailing address

4234 Illinois Ave
Fort Leonard Wood, MO 65583-9098

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Medical Physician Assistant Primary 363AM0700XNone listed
Military Health Care Provider 171000000XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1699401919

Dallas Carranza, PA's National Provider Identifier is 1699401919, issued on Jul 28, 2022. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Fort Leonard Wood, MO. The record was last updated on Aug 26, 2026.