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NPI Code Detail

MEDICARE: ANJU SUZANNA THOMAS MD

MEDICARE: ANJU SUZANNA THOMAS MD
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
1208000000XPediatrics PhysicianBP10070708TX
2208000000XPediatrics PhysicianU2337TX

General Provider Information

NPI Number : 1265052518
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANJU SUZANNA THOMAS MD
Provider Business Mailing Address
First Line : 301 UNIVERSITY BLVD
Second Line : DEPARTMENT OF PEDIATRICS, ROUTE 1119
City : GALVESTON
State : TX
Zip : 77555-1119
Country : US
Telephone Number : 409-772-2222
Fax Number : 409-772-3680
Provider Business Practice Location Address
First Line : 6416 BROADWAY ST
Second Line :
City : GALVESTON
State : TX
Zip : 77551-1033
Country : US
Telephone Number : 409-772-3695
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2020
Last Update Date : 06/09/2023

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