Provider Demographics
NPI:1942202213
Name:THOMAS, WILLIAM A (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-2835
Mailing Address - Country:US
Mailing Address - Phone:817-297-2811
Mailing Address - Fax:817-297-6629
Practice Address - Street 1:220 SW WILSHIRE BLVD.
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028
Practice Address - Country:US
Practice Address - Phone:817-447-8080
Practice Address - Fax:817-447-7627
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3851207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89071SOtherBCBS
TX0325680-02Medicaid
TX89071SOtherBCBS
TX0325680-02Medicaid