Provider Demographics
NPI:1609934868
Name:THOMAS, FLAVIA L (DO)
Entity Type:Individual
Prefix:
First Name:FLAVIA
Middle Name:L
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 CARTWRIGHT RD STE 303
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5309
Mailing Address - Country:US
Mailing Address - Phone:346-433-1579
Mailing Address - Fax:346-585-5076
Practice Address - Street 1:4220 CARTWRIGHT RD STE 303
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5309
Practice Address - Country:US
Practice Address - Phone:346-433-1579
Practice Address - Fax:346-585-5076
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8520207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112010701Medicaid
00272MMedicare ID - Type Unspecified
TX112010701Medicaid