Individual
LIDA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6411 FANNIN ST, HOUSTON, TX 77030-1501
(713) 500-6200
(713) 500-6264
Mailing address
PO BOX 201088, HOUSTON, TX 77216-1088
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
FTL 42152
TX
207L00000X
Anesthesiology Physician
Primary
FTL 42529
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192735201
—
TX
01
—
192735202
CSHCN
TX
01
—
81173Y
BCBS
TX
Enumeration date
02/28/2008
Last updated
06/01/2009
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