Provider Demographics
NPI:1508301094
Name:THOMAS, JAIME C (DME)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:C
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 690553
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549
Mailing Address - Country:US
Mailing Address - Phone:254-458-8534
Mailing Address - Fax:254-680-1997
Practice Address - Street 1:3921 E STAN SCHLUETER LOOP
Practice Address - Street 2:SUITE 105
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-6652
Practice Address - Country:US
Practice Address - Phone:254-458-8534
Practice Address - Fax:254-680-1997
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-20
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1617428332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies