Provider Demographics
NPI:1528419694
Name:THOMAS, MARSHA (OD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 WESLAYAN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5752
Mailing Address - Country:US
Mailing Address - Phone:713-526-1600
Mailing Address - Fax:713-526-0679
Practice Address - Street 1:3100 WESLAYAN ST STE 400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5752
Practice Address - Country:US
Practice Address - Phone:713-526-1600
Practice Address - Fax:713-526-0679
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8879T152W00000X
TX8879TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX359124003Medicaid
TX359124004Medicaid
TX359124002Medicaid