MEDICARE: MRS. NICOL THOMAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	14021879	TX

General Provider Information

NPI Number	:	1144034505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NICOL THOMAS

Provider Business Mailing Address
First Line	:	4076 DETROIT ST
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77703-2110
Country	:	US
Telephone Number	:	409-782-0127
Fax Number	:

Provider Business Practice Location Address
First Line	:	4076 DETROIT ST
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77703-2110
Country	:	US
Telephone Number	:	409-499-4194
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2025
Last Update Date	:	01/23/2026

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