Provider Demographics
NPI:1265432900
Name:THOMAS, DANIELE DASCY (MD)
Entity type:Individual
Prefix:
First Name:DANIELE
Middle Name:DASCY
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15910 TRANQUIL PARK CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6653
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
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2123207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124384212Medicaid
TX124384211Medicaid
TXE67869Medicare UPIN
TX8A7546Medicare ID - Type Unspecified
TXE67869Medicare UPIN