Provider Demographics
NPI:1093199325
Name:SAMMONS, DARCY (NP)
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:
Last Name:SAMMONS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DARCY
Other - Middle Name:
Other - Last Name:TERRAZAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:401 BROADWAY ST STE A
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7771
Mailing Address - Country:US
Mailing Address - Phone:512-805-5650
Mailing Address - Fax:512-392-4718
Practice Address - Street 1:401 BROADWAY ST STE A
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7771
Practice Address - Country:US
Practice Address - Phone:512-805-5650
Practice Address - Fax:512-392-4718
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX815346363L00000X
TXAP128044363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX349414802Medicaid
815745OtherMEDICARE
P02284043OtherRR MEDICARE