Provider Demographics
NPI:1104807221
Name:THOMAZY, VILMOS A (MD)
Entity type:Individual
Prefix:
First Name:VILMOS
Middle Name:A
Last Name:THOMAZY
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:PO BOX 164106
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78716-4106
Mailing Address - Country:US
Mailing Address - Phone:512-901-1206
Mailing Address - Fax:512-901-1299
Practice Address - Street 1:12221 N MOPAC EXPRESSWAY
Practice Address - Street 2:NAMC DEPARTMENT OF PATHOLOGY
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756
Practice Address - Country:US
Practice Address - Phone:512-901-1206
Practice Address - Fax:512-901-1299
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6670207ZP0102X
MI4301077314207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151922505Medicaid
TX151922507Medicaid
TX8K6433OtherBCBSTX
TX151922503Medicaid
TX151922504OtherCSHCN
TX151922504OtherCSHCN
TXP00238193Medicare PIN
TX8L5689Medicare PIN
TX8F4244Medicare PIN
TX151922503Medicaid