Autumn Semmelmann, PAC

Individual provider Active NPI Physician Assistant · Hereford, TX

NPI 1932298403 · NPPES record last updated Aug 23, 2011

Key facts

NPI
1932298403
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
PA03488 (TX)
Practice address
125 W Park Ave
Hereford, TX 79045-4201
Phone
(806) 364-7688
Fax
(806) 364-7694
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03488 TX Yes

Addresses

Primary practice location

125 W Park Ave
Hereford, TX 79045-4201

Mailing address

125 W Park Ave
Hereford, TX 79045-4201
Phone (806) 364-7688

Other providers in Hereford, TX

All providers in Hereford, TX · Physician Assistant in Texas

Sources for this page

Verify at the official NPI Registry.