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General NPI Number Information
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NPI Number | 1962737957
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Entity Type | Individual
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Provider Name | JEANNINE DENISE THOMAS PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/08/2009
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Last Update Date | 12/21/2025
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Provider Practice Location Address
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Address Line | 15614 HUEBNER RD STE 1059
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City | SAN ANTONIO
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State | TX
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Zip | 78248-0999
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Country | US
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Telephone | 210-775-0390
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Fax | 800-706-7601
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Provider Business Mailing Address
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Address Line | 27026 SMOKEY CHASE
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City | BOERNE
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State | TX
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Zip | 78015-6594
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Country | US
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Telephone | 210-775-0390
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Fax | 800-706-7601
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA06364
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License Number State | TX
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