Provider Demographics
NPI:1225630866
Name:THOMAS, DEBRA ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 HIGHWAY 71 W
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-3731
Mailing Address - Country:US
Mailing Address - Phone:512-321-1020
Mailing Address - Fax:512-321-4673
Practice Address - Street 1:488 HIGHWAY 71 W
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-3731
Practice Address - Country:US
Practice Address - Phone:512-321-1020
Practice Address - Fax:512-321-4673
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist