MEDICARE: MRS. STEPHANIE ANN TOMASEK N.P.

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	363LF0000X	Family Nurse Practitioner	AP111708	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730385261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE ANN TOMASEK N.P.

Provider Business Mailing Address
First Line	:	PO BOX 847556
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7556
Country	:	US
Telephone Number	:	254-231-1818
Fax Number	:

Provider Business Practice Location Address
First Line	:	2851 N MAIN ST STE 1
Second Line	:
City	:	BELTON
State	:	TX
Zip	:	76513-1109
Country	:	US
Telephone Number	:	254-939-1844
Fax Number	:	254-939-1619

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

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	11/10/2017

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