Provider Demographics
NPI:1255638029
Name:SHOEMAKER, MONICA LISA (PA-C)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:LISA
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E NOLANA AVE
Mailing Address - Street 2:SUITE 13A
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6104
Mailing Address - Country:US
Mailing Address - Phone:956-686-2700
Mailing Address - Fax:956-686-2708
Practice Address - Street 1:801 E NOLANA AVE
Practice Address - Street 2:SUITE 13A
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6104
Practice Address - Country:US
Practice Address - Phone:956-686-2700
Practice Address - Fax:956-686-2708
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07138363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant