Healthcare Provider Details

I. General information

NPI: 1538227178
Provider Name (Legal Business Name): CARLA E. THOMAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 06/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7432 W MILITARY DR
SAN ANTONIO TX
78227-2949
US

IV. Provider business mailing address

7432 W MILITARY DR
SAN ANTONIO TX
78227-2949
US

V. Phone/Fax

Practice location:
  • Phone: 210-645-9227
  • Fax:
Mailing address:
  • Phone: 210-645-9227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number118012
License Number StateTX

VIII. Authorized Official

Name: MRS. CARLA E THOMAS
Title or Position: OWNER
Credential:
Phone: 210-645-9227