Individual
DR. JUSTIN THOLANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7026 OLD KATY RD., SUITE 276, HOUSTON, TX 77024
(713) 621-7436
(713) 963-9051
Mailing address
7026 OLD KATY ROAD, SUITE 276, HOUSTON, TX 77024
(713) 621-7436
(713) 963-9051
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L8974
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00J245
MEDICARE GROUP
TX
01
—
083133101
MEDICAID GROUP
TX
01
—
10013919
AMERIGROUP
TX
05
—
165436001
—
TX
01
—
CS7910
MEDICARE RAILROAD GROUP
TX
01
—
P00101578
MEDICARE RAILROAD
TX
Enumeration date
05/26/2006
Last updated
08/08/2013
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