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General NPI Number Information
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NPI Number | 1336457696
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Entity Type | Organization
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Legal Business Name | PAT A. THOMAS, D.O., P.A.
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 09/21/2010
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Provider Practice Location Address
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Address Line | 701 PALUXY RD
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City | GRANBURY
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State | TX
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Zip | 76048-2355
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Country | US
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Telephone | 817-573-4585
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Fax | 682-498-8096
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Provider Business Mailing Address
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Address Line | 701 PALUXY RD
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City | GRANBURY
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State | TX
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Zip | 76048-2355
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Country | US
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Telephone | 817-573-4585
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Fax | 682-498-8096
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. PAT A. THOMAS
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Credential | D.O.
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Telephone | 817-573-4585
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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 | E8960
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License Number State | TX
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