Provider Demographics
NPI:1568043578
Name:THOMAS, RAHUL JACOB (MD)
Entity Type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:JACOB
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 LA CASCADA
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-2929
Mailing Address - Country:US
Mailing Address - Phone:404-951-6844
Mailing Address - Fax:
Practice Address - Street 1:UT HEALTH RGV - KNAPP FAMILY HEALTH CENTER
Practice Address - Street 2:2810 W EXPY 83
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570
Practice Address - Country:US
Practice Address - Phone:956-296-1816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX728439207QA0505X, 207Q00000X
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX06787306OtherTEXAS DEPARTMENT OF PUBLIC SAFETY
TX06787306OtherDRIVER LICENCE