Provider Demographics
NPI:1952149627
Name:MUMPUNI-SIMES, THOMAS ALAN (FNP-C, RN)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALAN
Last Name:MUMPUNI-SIMES
Suffix:
Gender:M
Credentials:FNP-C, RN
Other - Prefix:MR
Other - First Name:THOMAS
Other - Middle Name:ALAN
Other - Last Name:SIMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C, RN
Mailing Address - Street 1:1919 OAKWELL FARMS PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-1779
Mailing Address - Country:US
Mailing Address - Phone:480-712-8319
Mailing Address - Fax:480-712-1305
Practice Address - Street 1:135 FOREMOST DR APT 8101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-7385
Practice Address - Country:US
Practice Address - Phone:707-761-0659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1072267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily