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General NPI Number Information
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NPI Number | 1295014512
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Entity Type | Individual
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Provider Name | CHAD RYAN THOMAS C.S.F.A.
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Gender | Male
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 3317 S HIGLEY RD #114-257
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City | GILBERT
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State | AZ
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Zip | 85297-5436
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Country | US
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Telephone | 480-734-0536
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Fax | 480-539-4773
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Provider Business Mailing Address
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Address Line | 3317 S HIGLEY RD #114-257
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City | GILBERT
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State | AZ
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Zip | 85297-5436
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Country | US
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Telephone | 480-734-0536
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Fax | 480-539-4773
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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 | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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