NPI 1013153147

Donna Marie Prokop-Fettig, PAC

Practitioner Medical Physician Assistant Round Rock, TX

Practice location

Address: 1201 Sam Bass Rd, Round Rock, TX 78681-4137
Phone: (512) 388-1861
Fax: (512) 388-0373
Mailing address: PO Box 268945, Oklahoma City, OK 73126-8945

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence PA06103 (TX)

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Registry record

NPI: 1013153147
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Dec 2008
Record last updated: 14 Sep 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.