Provider Demographics
NPI:1952429649
Name:TOMA, GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:TOMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4144 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 360
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-3140
Mailing Address - Country:US
Mailing Address - Phone:214-827-7460
Mailing Address - Fax:
Practice Address - Street 1:4144 N CENTRAL EXPY
Practice Address - Street 2:SUITE 360
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-3140
Practice Address - Country:US
Practice Address - Phone:214-827-7460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0593207R00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2103555Medicaid
TX8CC139OtherBLUE CROSS BLUE SHIELD
TX204915701Medicaid
LA2103555Medicaid