Provider Demographics
NPI:1962413849
Name:THOMAS, CEALEE ANTREA (MD)
Entity type:Individual
Prefix:
First Name:CEALEE
Middle Name:ANTREA
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 1:3920 W WHEATLAND RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3401
Mailing Address - Country:US
Mailing Address - Phone:214-948-7779
Mailing Address - Fax:214-948-9977
Practice Address - Street 1:2505 N HWY 360
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-7818
Practice Address - Country:US
Practice Address - Phone:214-952-0829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9513207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R5288OtherBCBS PROVIDER #
TX8R5288OtherBCBS PROVIDER #