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NPI Code Detail

MEDICARE: NEAL THOMAS

MEDICARE: NEAL THOMAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1134494040
Entity Type Code : Individual
Provider Name (Legal Business Name) : NEAL THOMAS
Provider Business Mailing Address
First Line : 6045 EMMA BAY CT UNIT 102
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-3779
Country : US
Telephone Number : 702-468-6502
Fax Number : 702-823-5905
Provider Business Practice Location Address
First Line : 3624 RUSSIAN OLIVE ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-7643
Country : US
Telephone Number : 702-468-6502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2012
Last Update Date : 03/12/2012

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Directions to “ NEAL THOMAS ” Practice Location

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