Provider Demographics
NPI:1013629138
Name:NASH, THOMAS CHASE (PA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:CHASE
Last Name:NASH
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 1:6805 WINDHAVEN PKWY APT 306
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-5258
Mailing Address - Country:US
Mailing Address - Phone:662-275-9152
Mailing Address - Fax:
Practice Address - Street 1:4201 MEDICAL CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1766
Practice Address - Country:US
Practice Address - Phone:469-796-4295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16568363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty