Healthcare Provider Details

I. General information

NPI: 1477915668
Provider Name (Legal Business Name): ELIZABETH THOMAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2016
Last Update Date: 07/07/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 BARBARA JORDAN BLVD STE 200
AUSTIN TX
78723-3078
US

IV. Provider business mailing address

2848 ESTURION ST
CARLSBAD CA
92009-4417
US

V. Phone/Fax

Practice location:
  • Phone: 512-628-1860
  • Fax:
Mailing address:
  • Phone: 760-814-0593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberT7752
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: