Provider Demographics
NPI:1912940875
Name:THELMA I HOEHN
Entity Type:Organization
Organization Name:THELMA I HOEHN
Other - Org Name:THELMA'S HOME TOWN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:I
Authorized Official - Last Name:HOEHN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:940-726-5750
Mailing Address - Street 1:PO BOX 438
Mailing Address - Street 2:
Mailing Address - City:VALLEY VIEW
Mailing Address - State:TX
Mailing Address - Zip Code:76272-0438
Mailing Address - Country:US
Mailing Address - Phone:940-726-5750
Mailing Address - Fax:940-726-5721
Practice Address - Street 1:801 I-35 FRONTAGE RD WEST
Practice Address - Street 2:SUITE 3
Practice Address - City:VALLEY VIEW
Practice Address - State:TX
Practice Address - Zip Code:76272-9709
Practice Address - Country:US
Practice Address - Phone:940-726-5750
Practice Address - Fax:940-726-5721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXFNP-LPA363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181560701Medicaid
TX00W535Medicare PIN