Provider Demographics
NPI:1194528778
Name:THOMAS, EMERSON RAE (DO)
Entity type:Individual
Prefix:DR
First Name:EMERSON
Middle Name:RAE
Last Name:THOMAS
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 SILENT HOLW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-6251
Mailing Address - Country:US
Mailing Address - Phone:210-422-3396
Mailing Address - Fax:
Practice Address - Street 1:7615 KENNEDY HL BLDG 2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235-4438
Practice Address - Country:US
Practice Address - Phone:210-890-4243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program