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Individual

MS. ALICIA M LEWIS THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1020 EDGEFIELD LN, FORNEY, TX 75126
(972) 552-1057
Mailing address
1020 EDGEFIELD LN, FORNEY, TX 75126-3817
(972) 552-1057

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
247200000X
TAXONOMY
TX
Enumeration date
06/15/2017
Last updated
07/21/2022
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