Kanoklukul, Tamsak

Kanoklukul, Tamsak is an individual health care provider with primary practice located at 100 Hillcrest Medical Blvd , Waco TX 76712-8897. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Kanoklukul, Tamsak can be contacted via phone (254) 202-5800.

Contact Information

Primary practice address
100 Hillcrest Medical Blvd Waco TX 76712-8897
Phone: (254) 202-5800
Fax: (254) 202-5849
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 560268 Texas

Profile Details

NPI number 1639177462
LBN Legal business name Kanoklukul, Tamsak
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Nov 16th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639177462 NPPES
Texas MEDICAID 003459701

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