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General NPI Number Information
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NPI Number | 1689874307
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Entity Type | Organization
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Legal Business Name | M. ANGELA THOMAS, MD, PC
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 05/10/2010
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Provider Practice Location Address
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Address Line | 2510 WIGWAM PKWY SUITE 201
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City | HENDERSON
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State | NV
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Zip | 89074-7114
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Country | US
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Telephone | 702-457-7463
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Fax | 702-878-7463
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Provider Business Mailing Address
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Address Line | 2510 WIGWAM PKWY SUITE 201
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City | HENDERSON
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State | NV
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Zip | 89074-7114
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Country | US
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Telephone | 702-457-7463
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Fax | 702-878-7463
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JILL ELAINE MOORE
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Credential |
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Telephone | 702-457-7463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 11173
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License Number State | NV
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