Individual
SHIRLEY KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
210 S AVENUE C, CRYSTAL CITY, TX 78839-3834
(830) 374-2952
(830) 374-3784
Mailing address
PO BOX 725, CRYSTAL CITY, TX 78839-0725
(830) 374-2952
(830) 374-3784
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
92PA01
NM
363AM0700X
Medical Physician Assistant
Primary
PA01316
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
96694
—
NM
Enumeration date
10/06/2006
Last updated
05/11/2022
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