Marissa B Bothun, P.A.-C.

NPI #1942507207 in Rockwall, Texas

Provider Information

NPI Number: 1942507207
Entity Type: Individual
Name: Marissa B Bothun, P.A.-C.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.-C.
Enumeration Date: Feb 23, 2011
Last Updated: Dec 8, 2025

Practice Location

Address: 1020 W RALPH HALL PKWY STE 102
City: Rockwall
State: Texas
ZIP Code: 75032-8711
Phone: (972) 390-9002

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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