Provider Demographics
NPI:1811442395
Name:THOMAS, ANA (NUTRITIONIST)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3713 PATIENCE BLVD E
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75236-3035
Mailing Address - Country:US
Mailing Address - Phone:972-803-5563
Mailing Address - Fax:
Practice Address - Street 1:433 CASTLE ST
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4998
Practice Address - Country:US
Practice Address - Phone:214-212-1828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-24
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No1744P3200XOther Service ProvidersSpecialistProsthetics Case Management