Provider Demographics
NPI:1366486292
Name:THOMAS, CHRISTOPHER BRYAN (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRYAN
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 919237
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-9237
Mailing Address - Country:US
Mailing Address - Phone:877-988-1890
Mailing Address - Fax:
Practice Address - Street 1:8585 PICARDY AVE STE 313
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3749
Practice Address - Country:US
Practice Address - Phone:225-381-2755
Practice Address - Fax:225-381-2759
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA203130207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1884669Medicaid
LA4M018DD21OtherMEDICARE
LAP00821656OtherRAILROAD MEDICARE
KY7100030970OtherKENTUCKY MEDICAID
TN4144466OtherBLUE CROSS
TN3333946Medicaid