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General NPI Number Information
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NPI Number | 1366402265
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Entity Type | Individual
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Provider Name | SHIBU THOMAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 221 W COLORADO BLVD PAVILION 2 SUITE 929
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City | DALLAS
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State | TX
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Zip | 75208-2363
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Country | US
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Telephone | 214-960-5681
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Fax | 214-947-2727
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Provider Business Mailing Address
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Address Line | 5605 N MACARTHUR BLVD STE 740
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City | IRVING
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State | TX
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Zip | 75038-2626
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Country | US
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Telephone | 214-960-5681
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Fax | 214-947-2727
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | M2840
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | M2840
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License Number State | TX
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