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Individual

DR. BOB THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3501 KNICKERBOCKER RD, SAN ANGELO, TX 76904-7610
(325) 949-9555
Mailing address
3605 EXECUTIVE DR, SAN ANGELO, TX 76904-6884
(325) 949-9555

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E1153
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102664301
TX
01
821798
BLUE CROSS/BLUE SHIELD TX
TX
Enumeration date
05/01/2006
Last updated
12/05/2018
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