Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1334 | TX |
Y | 222Z00000X | Podiatrist | 1334 | TX |
N | 213EP0504X | Public Medicine | 1334 | TX |
N | 213EP1101X | Primary Podiatric Medicine | 1334 | TX |
N | 111NR0200X | Radiology | 1334 | TX |
N | 213ER0200X | Radiology | 1334 | TX |
N | 2081S0010X | Sports Medicine | 1334 | TX |
N | 213ES0000X | Sports Medicine | 1334 | TX |
N | 213ES0103X | Foot & Ankle Surgery | 1334 | TX |
N | 213ES0131X | Foot Surgery | 1334 | TX |
NPI | 1669530523 |
---|---|
Provider Name | Dr. Wilburn Earl Thomas |
First Address | San Antonio, TX 78223-2216 |
Second Address | San Antonio, TX 78223-2216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 07/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018591001 | (05) | TX |
U66864 | (02) | TX |