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NPI Code Detail

MEDICARE: DANIEL L THOMAS OD

MEDICARE: DANIEL L THOMAS OD
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
1152W00000XOptometristTA2410MD
2152W00000XOptometristOP1000296DC
3152W00000XOptometrist0618002351VA

General Provider Information

NPI Number : 1962816421
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL L THOMAS OD
Provider Business Mailing Address
First Line : 1950 OLD GALLOWS RD
Second Line : SUITE 520
City : VIENNA
State : VA
Zip : 22182-3990
Country : US
Telephone Number : 703-847-8899
Fax Number :
Provider Business Practice Location Address
First Line : 13531 CONNECTICUT AVE
Second Line :
City : ASPEN HILL
State : MD
Zip : 20906-2912
Country : US
Telephone Number : 301-438-0555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2014
Last Update Date : 03/09/2016

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