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NPI Code Detail

MEDICARE: RENEE THOMAS

MEDICARE: RENEE 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
1363LF0000XFamily Nurse Practitioner125815TX

General Provider Information

NPI Number : 1912306655
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE THOMAS
Provider Business Mailing Address
First Line : 5959 LONG PRAIRIE RD
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75028-2224
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5959 LONG PRAIRIE RD
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75028-2224
Country : US
Telephone Number : 972-874-3670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2014
Last Update Date : 01/09/2016

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Directions to “ RENEE THOMAS ” Practice Location

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