MEDICARE: JONATHAN THAI

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	183500000X	Pharmacist	125328	MN

General Provider Information

NPI Number	:	1144997990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN THAI

Provider Business Mailing Address
First Line	:	3033 W PRESIDENT GEORGE BUSH HWY STE 100B
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-5885
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3033 W PRESIDENT GEORGE BUSH HWY STE 100B
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-5885
Country	:	US
Telephone Number	:	972-588-1040
Fax Number	:

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

Provider Enumeration Date	:	08/27/2021
Last Update Date	:	06/30/2026

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Directions to “ JONATHAN THAI ” Practice Location

Language	Start Address	Practice Location

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