MEDICARE: DR. KACI MARIE THOMAS MD

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	207Q00000X	Family Medicine Physician	BP10059434	TX
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	S6771	TX
3	207Q00000X	Family Medicine Physician	S6771	TX

General Provider Information

NPI Number	:	1245769223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KACI MARIE THOMAS MD

Provider Business Mailing Address
First Line	:	1430 COLLIER ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-2911
Country	:	US
Telephone Number	:	512-447-4141
Fax Number	:

Provider Business Practice Location Address
First Line	:	1631 E 2ND ST STE A
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78702-4491
Country	:	US
Telephone Number	:	512-804-3380
Fax Number	:

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

Provider Enumeration Date	:	06/05/2017
Last Update Date	:	02/18/2026

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