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General NPI Number Information
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NPI Number | 1164439303
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Entity Type | Individual
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Provider Name | FRED C. THOMAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 06/15/2011
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Provider Practice Location Address
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Address Line | 9353 ELAM RD
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City | DALLAS
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State | TX
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Zip | 75217-4181
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Country | US
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Telephone | 214-931-1158
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Fax | 214-398-0212
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Provider Business Mailing Address
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Address Line | 9353 ELAM RD
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City | DALLAS
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State | TX
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Zip | 75217-4181
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Country | US
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Telephone | 214-931-1158
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Fax | 214-398-0212
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G1785
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License Number State | TX
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