Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0400X | Rehabilitation Chiropractor | 9122 | TX |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 783003 | TX |
NPI | 1164582011 |
---|---|
Provider Name | Dr. Sie Yeon Thomas |
First Address | Dallas, TX 75373-2917 |
Second Address | Dallas, TX 75228-2693 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 02/09/2015 |