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General NPI Number Information
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NPI Number | 1720259088
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Entity Type | Individual
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Provider Name | PRAMOD K THOMAS DDS
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Gender | Male
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Dates
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Enumeration Date | 03/14/2008
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Last Update Date | 10/14/2009
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Provider Practice Location Address
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Address Line | 445 WALNUT ST #133
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City | RICHARDSON
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State | TX
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Zip | 75081-5649
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Country | US
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Telephone | 972-238-7233
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Fax | 972-238-8993
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Provider Business Mailing Address
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Address Line | 445 E WALNUT ST. #133
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City | RICHARDSON
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State | TX
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Zip | 75081-5584
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Country | US
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Telephone | 972-238-7233
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Fax | 972-238-8993
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 23752
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License Number State | TX
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