Individual
DR. FRED C. THOMAS
Active
Individual
DR. FRED C. THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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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