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Individual

MELISSA THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
125.072891
IL
208000000X
Pediatrics Physician
Primary
T5225
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
124.0272891
TEMPORARY MEDICAL PERMIT
IL
01
T5225
MEDICAL LICENSE
TX
Enumeration date
04/03/2018
Last updated
09/30/2024
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