Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 524565 | TX |
NPI | 1073513362 |
---|---|
Provider Name | Joise A. Thomas |
First Address | Dallas, TX 75266-0599 |
Second Address | Dallas, TX 75235-7708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 16/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
144924101 | (05) | TX |
144924102 | (05) | TX |
144924103 | (05) | TX |
144924104 | (05) | TX |
144924105 | (05) | TX |
144924106 | (05) | TX |
144924107 | (05) | TX |
144924108 | (05) | TX |
144924109 | (05) | TX |
144924110 | (05) | TX |
144924111 | (05) | TX |
144924112 | (05) | TX |
8N4778 | BLUE CROSS BLUE SHIELD (01) | TX |