Provider Demographics
NPI:1427008218
Name:THOMAS, GENEVIEVE C (CRNA)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:C
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 WATER ST
Mailing Address - Street 2:#105-B
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5200
Mailing Address - Country:US
Mailing Address - Phone:830-896-1344
Mailing Address - Fax:830-896-1363
Practice Address - Street 1:420 WATER ST
Practice Address - Street 2:#105-B
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5200
Practice Address - Country:US
Practice Address - Phone:830-896-1344
Practice Address - Fax:830-896-1363
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229581367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80001CMedicare ID - Type Unspecified