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NPI Code Detail

MEDICARE: MRS. PONMARY THOMAS FNP

MEDICARE: MRS. PONMARY THOMAS FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209009337IL
2363LF0000XFamily Nurse Practitioner1875TX

General Provider Information

NPI Number : 1902176662
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PONMARY THOMAS FNP
Provider Business Mailing Address
First Line : 1036 N CIRCLE DR
Second Line :
City : SEALY
State : TX
Zip : 77474-3336
Country : US
Telephone Number : 979-877-0022
Fax Number :
Provider Business Practice Location Address
First Line : 1036 N CIRCLE DR
Second Line :
City : SEALY
State : TX
Zip : 77474-3336
Country : US
Telephone Number : 979-877-0022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2012
Last Update Date : 08/01/2013

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Directions to “ MRS. PONMARY THOMAS FNP” Practice Location

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