Organization
VAP
Active
Organization
VAP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS JEFFERSON (PRACTICE CONSULTANT)
(972) 999-1659
Entity
Organization
Contact information
Practice address
8616 GREENVILLE AVE STE 101A, DALLAS, TX 75243-7166
(972) 999-1659
(972) 805-2777
Mailing address
8616 GREENVILLE AVE STE 101, DALLAS, TX 75243-7166
(972) 999-1659
(972) 805-2777
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/24/2023
Last updated
10/20/2025
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