Provider Demographics
NPI:1164138830
Name:MYERS, TOMAS TROBLY (PA)
Entity Type:Individual
Prefix:
First Name:TOMAS
Middle Name:TROBLY
Last Name:MYERS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 52158
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-2158
Mailing Address - Country:US
Mailing Address - Phone:806-354-9764
Mailing Address - Fax:806-355-2728
Practice Address - Street 1:6200 W I 40
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2512
Practice Address - Country:US
Practice Address - Phone:806-354-9764
Practice Address - Fax:806-355-2728
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16464363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant