Provider Demographics
NPI:1710093976
Name:THOMAS, JOHN ABRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ABRAHAM
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:ABRAHAM
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:215 OLD HIGHWAY 1187
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-0281
Mailing Address - Country:US
Mailing Address - Phone:817-926-2663
Mailing Address - Fax:817-293-8860
Practice Address - Street 1:215 OLD HIGHWAY 1187
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-0281
Practice Address - Country:US
Practice Address - Phone:817-926-2663
Practice Address - Fax:817-293-8860
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8215207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7377574OtherAETNA
TX8X2340OtherBCBS
H86179Medicare UPIN
TX7377574OtherAETNA