Individual
CICIMOL THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6000 BRYANT IRVIN RD, FORT WORTH, TX 76132-4116
(866) 389-2727
Mailing address
150 GINGER CT, SOUTHLAKE, TX 76092-6046
(305) 801-6448
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1134263
TX
Other
Enumeration date
09/04/2023
Last updated
10/28/2025
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