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General NPI Number Information
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NPI Number | 1942465786
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Entity Type | Individual
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Provider Name | THOMAS M. NUNN P.A.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 222 SIDNEY BAKER ST S SUITE 500
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City | KERRVILLE
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State | TX
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Zip | 78028-5994
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Country | US
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Telephone | 830-895-7675
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Fax | 830-896-3082
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Provider Business Mailing Address
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Address Line | 222 SIDNEY BAKER ST SOUTH SUITE 500
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City | KERRVILLE
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State | TX
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Zip | 78028-5900
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Country | US
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Telephone | 830-895-7675
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Fax | 830-896-3082
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 02172
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License Number State | TX
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