Individual provider · Type 1 NPI

Alice Civitello, PA - C

Medical Physician Assistant · Houston, TX

NPI number 1922402841 Active

Practice location

6620 Main St, Ste 1225
Houston, TX 77030-2348

Fax (713) 798-2578

Mailing address

1 Baylor Plz
Houston, TX 77030-3411

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA00385 (TX)

Medical Physician Assistant: Definition to come...

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About NPI 1922402841

Alice Civitello, PA - C's National Provider Identifier is 1922402841, issued on Oct 21, 2014. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Houston, TX. The record was last updated on Oct 21, 2014.