Individual
MICHAEL RYAN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
912 S PECAN ST, VIVIAN, LA 71082-3350
(318) 375-2203
Mailing address
9006 SUNDANCE LN, SHREVEPORT, LA 71106-7788
(318) 990-9932
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
242109
LA
Other
Enumeration date
06/26/2025
Last updated
06/26/2025
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