Individual
ANITTA VARGHESE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2360 GUS THOMASSON RD, DALLAS, TX 75228-3005
(214) 396-0348
Mailing address
4642 SHIVERS LN, FORNEY, TX 75126-3389
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601009711
MI
Other
Enumeration date
05/15/2019
Last updated
04/05/2022
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