Provider Demographics
NPI:1316367360
Name:THOMAS, THOMAS VADOPPARAMBIL (PHARM D, RPH)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:VADOPPARAMBIL
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2556 SIR TRISTRAM LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-5706
Mailing Address - Country:US
Mailing Address - Phone:972-899-2244
Mailing Address - Fax:972-899-2244
Practice Address - Street 1:2556 SIR TRISTRAM LN
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75056-5706
Practice Address - Country:US
Practice Address - Phone:972-899-2244
Practice Address - Fax:972-899-2244
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36368183500000X
PARP042726L1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy