Healthcare Provider Details

I. General information

NPI: 1295964591
Provider Name (Legal Business Name): THOMAS F NOHE PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 01/24/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 4TH ST
BLANCO TX
78606-4913
US

IV. Provider business mailing address

825 4TH ST
BLANCO TX
78606-4913
US

V. Phone/Fax

Practice location:
  • Phone: 830-833-5581
  • Fax: 830-833-4933
Mailing address:
  • Phone: 830-833-5581
  • Fax: 830-833-4933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: