Provider Demographics
NPI:1548754161
Name:THOMAS, ERNEST (DDS)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17244 INTERSTATE 35 N STE 5
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-1397
Mailing Address - Country:US
Mailing Address - Phone:210-836-9911
Mailing Address - Fax:
Practice Address - Street 1:17244 I-35 NORTH
Practice Address - Street 2:SUITE 5
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154
Practice Address - Country:US
Practice Address - Phone:210-241-7129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice