Provider Demographics
NPI:1942482534
Name:DANIELE THOMAS, MD, PA
Entity Type:Organization
Organization Name:DANIELE THOMAS, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELE
Authorized Official - Middle Name:D
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-717-0587
Mailing Address - Street 1:PO BOX 12105
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77391-2105
Mailing Address - Country:US
Mailing Address - Phone:832-717-0587
Mailing Address - Fax:832-717-3164
Practice Address - Street 1:15910 TRANQUIL PARK CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6653
Practice Address - Country:US
Practice Address - Phone:832-717-0587
Practice Address - Fax:832-717-3164
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANIELE THOMAS, MD, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-05
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160406801Medicaid
TX00304VMedicare PIN