Provider Demographics
NPI:1144508912
Name:MIDDLETON, VELISLAVA SACHEVA (PA-C)
Entity type:Individual
Prefix:MS
First Name:VELISLAVA
Middle Name:SACHEVA
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 CHISHOLM TRL
Mailing Address - Street 2:
Mailing Address - City:KRUM
Mailing Address - State:TX
Mailing Address - Zip Code:76249-7176
Mailing Address - Country:US
Mailing Address - Phone:214-499-4107
Mailing Address - Fax:
Practice Address - Street 1:324 CHISHOLM TRL
Practice Address - Street 2:
Practice Address - City:KRUM
Practice Address - State:TX
Practice Address - Zip Code:76249-7176
Practice Address - Country:US
Practice Address - Phone:214-499-4107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07543363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant