Individual
MR. THOMAS EARL HIMELICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MMSC
Contact information
Practice address
BIA ROUTE 125, PINE HILL HEALTH CENTER, PINEHILL, NM 87357
(505) 775-3271
Mailing address
HC 61 BOX 5022, RAMAH, NM 87321-9803
(505) 783-4047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2002-0034
NM
Other
Enumeration date
11/12/2009
Last updated
09/16/2020
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