Provider Demographics
NPI:1033814603
Name:THOMAS, JEFFREY (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 ALSDORF RD
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-7489
Mailing Address - Country:US
Mailing Address - Phone:806-290-4875
Mailing Address - Fax:
Practice Address - Street 1:3535 N BUCKNER BLVD STE 150
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-5876
Practice Address - Country:US
Practice Address - Phone:214-782-9901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15166111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor