Individual
DR. FRED C. THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9353 ELAM RD, DALLAS, TX 75217-4181
(214) 931-1158
(214) 398-0212
Mailing address
9353 ELAM RD, DALLAS, TX 75217-4181
(214) 931-1158
(214) 398-0212
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G1785
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012EA
BLUE SHIELD
TX
01
—
10838892
CAQH
—
05
—
130899104
—
TX
05
—
130899106
—
TX
Enumeration date
08/01/2006
Last updated
06/15/2011
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