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General NPI Number Information
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NPI Number | 1669933701
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Entity Type | Individual
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Provider Name | JUSTIN JOHN THOMAS MD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2019
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Last Update Date | 05/17/2024
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Provider Practice Location Address
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Address Line | 1501 BURNET RD
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City | BROWNWOOD
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State | TX
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Zip | 76801-8520
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Country | US
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Telephone | 325-649-5000
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Fax | 325-649-3935
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Provider Business Mailing Address
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Address Line | 1501 BURNET RD
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City | BROWNWOOD
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State | TX
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Zip | 76801-8520
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Country | US
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Telephone | 325-649-5000
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | T7375
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License Number State | TX
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