Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | N7592 | TX |
NPI | 1366680860 |
---|---|
Provider Name | Dr. Carolyn Ley Thomas |
First Address | Dallas, TX 75391-1230 |
Second Address | Dallas, TX 75231-4339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2009 |
Last Update Date | 20/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
306587204 | (05) | TX |
306587205 | (05) | TX |