Provider Demographics
NPI:1497780696
Name:THOMAS, WINIFRED NANCY (MD)
Entity Type:Individual
Prefix:
First Name:WINIFRED
Middle Name:NANCY
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9411 N LAMAR BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-4179
Mailing Address - Country:US
Mailing Address - Phone:512-744-6000
Mailing Address - Fax:512-279-0781
Practice Address - Street 1:9411 N LAMAR BLVD STE 120
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-4179
Practice Address - Country:US
Practice Address - Phone:512-744-6000
Practice Address - Fax:512-279-0781
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2316208000000X
OH35086523208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2567922Medicaid
TX3562811Medicaid
OH2567922Medicaid