Provider Demographics
NPI:1376270199
Name:THOMAS, CHELSEA LYNN
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LYNN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10835 FLYING FURY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-6208
Mailing Address - Country:US
Mailing Address - Phone:210-372-6236
Mailing Address - Fax:
Practice Address - Street 1:11212 STATE HIGHWAY 151 STE 120
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4498
Practice Address - Country:US
Practice Address - Phone:726-223-2775
Practice Address - Fax:726-223-3120
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1089073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily