Provider Demographics
NPI:1629417829
Name:GIANARIS, THOMAS JULIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JULIAN
Last Name:GIANARIS
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 1:6020 W PARKER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8172
Mailing Address - Country:US
Mailing Address - Phone:972-473-3947
Mailing Address - Fax:
Practice Address - Street 1:2925 E BROAD ST STE 101
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-9184
Practice Address - Country:US
Practice Address - Phone:317-396-1234
Practice Address - Fax:682-518-5771
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-20
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS7218207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS7218OtherTMB