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General NPI Number Information
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NPI Number | 1033709415
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Entity Type | Individual
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Provider Name | DIANA ELAINE THOMAS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/20/2021
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 101 AVENUE J
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City | ANSON
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State | TX
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Zip | 79501-2198
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Country | US
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Telephone | 325-823-1166
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Fax |
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Provider Business Mailing Address
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Address Line | 4515 COUNTY ROAD 320
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City | ABILENE
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State | TX
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Zip | 79601-8027
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Country | US
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Telephone | 325-518-8076
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F01210849
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1029549
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License Number State | TX
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