Provider Demographics
NPI:1639125529
Name:THOMAS, STUART N (MD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:N
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 1:409 CENTRAL PARK DR.
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2907
Mailing Address - Country:US
Mailing Address - Phone:817-261-9191
Mailing Address - Fax:817-784-6880
Practice Address - Street 1:409 CENTRAL PARK DR.
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014
Practice Address - Country:US
Practice Address - Phone:817-261-9191
Practice Address - Fax:817-784-6880
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5652207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N02UMedicare ID - Type Unspecified
TXF92856Medicare UPIN