=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881056638
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BETTY THOMAS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2016
-----------------------------------------------------
Last Update Date | 12/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4004 MEDICAL PKWY
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75401-7854
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-893-5637
-----------------------------------------------------
Fax | 817-666-3873
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2340 E TRINITY MILLS RD STE 250
-----------------------------------------------------
City | CARROLLTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75006-1946
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-886-4455
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | AP128913
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------