Provider Demographics
NPI:1447483789
Name:FEARIN, ELIZABETH BARKER (PA-C, MPAS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BARKER
Last Name:FEARIN
Suffix:
Gender:F
Credentials:PA-C, MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 ELDORADO PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7550
Mailing Address - Country:US
Mailing Address - Phone:972-548-2797
Mailing Address - Fax:972-548-2788
Practice Address - Street 1:2251 ELDORADO PKWY STE 150
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:972-548-2797
Practice Address - Fax:972-548-2788
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08756363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0075063Medicaid
OHPA34711Medicare PIN
TX368997ZJSUMedicare PIN