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General NPI Number Information
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NPI Number | 1508301094
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Entity Type | Individual
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Provider Name | JAIME C THOMAS DME
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Gender | Female
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Dates
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Enumeration Date | 12/20/2016
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 3921 E STAN SCHLUETER LOOP SUITE 105
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City | KILLEEN
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State | TX
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Zip | 76542-6652
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Country | US
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Telephone | 254-458-8534
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Fax | 254-680-1997
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Provider Business Mailing Address
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Address Line | PO BOX 690553
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City | KILLEEN
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State | TX
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Zip | 76549
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Country | US
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Telephone | 254-458-8534
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Fax | 254-680-1997
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1617428
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 1617428
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License Number State | TX
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