Provider Demographics
NPI:1124099346
Name:THOMAS, MARY ANGELA (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANGELA
Last Name:THOMAS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:6900 PECOS RD
Mailing Address - Street 2:VA MEDICAL CENTER
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-4400
Mailing Address - Country:US
Mailing Address - Phone:702-791-9000
Mailing Address - Fax:702-224-6910
Practice Address - Street 1:6900 PECOS RD
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-4400
Practice Address - Country:US
Practice Address - Phone:702-791-9000
Practice Address - Fax:702-224-6910
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2016-01-15
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Provider Licenses
StateLicense IDTaxonomies
NV11173208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
H16416Medicare UPIN
NVV104129Medicare PIN
H16416Medicare UPIN