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NPI Code Detail

MEDICARE: SHELBY ELIZABETH THOMAS PA-C

MEDICARE:   SHELBY ELIZABETH THOMAS  PA-C
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
1363A00000XPhysician AssistantPA14781TX

General Provider Information

NPI Number : 1699347450
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY ELIZABETH THOMAS PA-C
Provider Business Mailing Address
First Line : 701 WOODED CREST DR
Second Line :
City : WACO
State : TX
Zip : 76712-3271
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1135 N LOOP 340
Second Line :
City : WACO
State : TX
Zip : 76705-2486
Country : US
Telephone Number : 254-867-1962
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2021
Last Update Date : 07/12/2021

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Directions to “ SHELBY ELIZABETH THOMAS PA-C” Practice Location

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