Healthcare Provider Details

I. General information

NPI: 1124037551
Provider Name (Legal Business Name): MILTON DEAN THOMAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 11/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 N WASHINGTON AVE
DALLAS TX
75246-1520
US

IV. Provider business mailing address

909 N WASHINGTON AVE
DALLAS TX
75246-1520
US

V. Phone/Fax

Practice location:
  • Phone: 214-820-9637
  • Fax: 214-820-9339
Mailing address:
  • Phone: 214-820-9637
  • Fax: 214-820-9339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberJ0698
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: