Provider Demographics
NPI:1619459427
Name:THOMAS, DAVID EUGENE
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:EUGENE
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10405 HARVEST HILLS RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-4039
Mailing Address - Country:US
Mailing Address - Phone:405-881-4059
Mailing Address - Fax:
Practice Address - Street 1:10405 HARVEST HILLS RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-4039
Practice Address - Country:US
Practice Address - Phone:405-881-4059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist