MEDICARE: WANDA JEAN SILMON CSFA

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
1	246ZC0007X	Surgical Assistant
2	363AS0400X	Surgical Physician Assistant

General Provider Information

NPI Number	:	1184457061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WANDA JEAN SILMON CSFA

Provider Business Mailing Address
First Line	:	1213 PAUL DR
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-6215
Country	:	US
Telephone Number	:	469-765-5298
Fax Number	:

Provider Business Practice Location Address
First Line	:	1213 PAUL DR
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-6215
Country	:	US
Telephone Number	:	469-765-5298
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	02/05/2025

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Directions to “ WANDA JEAN SILMON CSFA” Practice Location

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