Individual
MS. BEENA M THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K9434
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017PC
BCBS GROUP ID
TX
01
—
201032630
TAX ID
TX
01
—
8W9481
BCBS INDIVIDUAL ID
TX
01
—
K9434
MEDICAL LICENSE
TX
Enumeration date
10/11/2006
Last updated
06/01/2009
Update your record
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