Provider Demographics
NPI:1891135125
Name:THOMAS, LIJA L (MD)
Entity Type:Individual
Prefix:
First Name:LIJA
Middle Name:L
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 360541
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-6541
Mailing Address - Country:US
Mailing Address - Phone:972-525-9900
Mailing Address - Fax:469-333-7988
Practice Address - Street 1:1020 N COLLINS ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-6134
Practice Address - Country:US
Practice Address - Phone:972-525-9900
Practice Address - Fax:469-333-7988
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD191023207Q00000X
LA303932207Q00000X
MS889-L207Q00000X
TXS4065207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100088706Medicaid
TX1A1371OtherMEDICARE
TX410493701Medicaid
MS05784011Medicaid
LA2433504Medicaid
TXP0246294OtherMEDICARE RAIL ROAD
TX8MK865OtherBCBS