Provider Demographics
NPI:1043384530
Name:THOMAS FAMILY PRACTICE, LTD.
Entity Type:Organization
Organization Name:THOMAS FAMILY PRACTICE, LTD.
Other - Org Name:TRIANGLE FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:QUINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-331-6400
Mailing Address - Street 1:PO BOX 34120
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89533-4120
Mailing Address - Country:US
Mailing Address - Phone:775-747-5050
Mailing Address - Fax:
Practice Address - Street 1:1475 TERMINAL WAY
Practice Address - Street 2:SUITE A1
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3430
Practice Address - Country:US
Practice Address - Phone:775-331-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100248Medicare ID - Type Unspecified