Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | D4333 | TX |
NPI | 1013349646 |
---|---|
Provider Name | Dr. Walter Neal Thomas |
First Address | Weimar, TX 78962-5117 |
Second Address | Weimar, TX 78962-5117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2013 |
Last Update Date | 06/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
115135901 | (05) | TX |