Provider Demographics
NPI:1639771082
Name:THOMAS, LUCRETIA M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LUCRETIA
Middle Name:M
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 WATERFORD OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-9143
Mailing Address - Country:US
Mailing Address - Phone:504-710-3200
Mailing Address - Fax:972-293-1257
Practice Address - Street 1:2225 W I 20
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3926
Practice Address - Country:US
Practice Address - Phone:972-660-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist