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General NPI Number Information
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NPI Number | 1609013929
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Entity Type | Individual
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Provider Name | TANGY NICOLE KINCAID THOMAS CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 03/29/2026
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Provider Practice Location Address
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Address Line | 1411 N BECKLEY AVE
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City | DALLAS
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State | TX
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Zip | 75203-1259
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Country | US
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Telephone | 214-948-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 144 MAVERICK LN
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City | FORNEY
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State | TX
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Zip | 75126-0625
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Country | US
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Telephone | 469-750-4025
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 777455
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP117858
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License Number State | TX
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