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General NPI Number Information
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NPI Number | 1891135125
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Entity Type | Individual
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Provider Name | LIJA L THOMAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1604 LANCASTER DR
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City | GRAPEVINE
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State | TX
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Zip | 76051-3544
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Country | US
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Telephone | 855-893-5637
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Fax | 817-666-3873
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Provider Business Mailing Address
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Address Line | 2340 E TRINITY MILLS RD STE 250
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City | CARROLLTON
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State | TX
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Zip | 75006-1946
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Country | US
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Telephone | 972-417-8937
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD191023
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 303932
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 889-L
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | S4065
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License Number State | TX
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