Provider Demographics
NPI:1396135083
Name:THOMAS, JASON M (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:M
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:SAN ANTONIO MILITARY MEDICAL CENTER, 959 MDOS/SGO5P
Mailing Address - Street 2:PULMONARY/CRITICAL CARE, 3551 ROGER BROOKE DR
Mailing Address - City:JBSA-FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-2153
Mailing Address - Fax:210-916-0709
Practice Address - Street 1:SAN ANTONIO MILITARY MEDICAL CENTER, MCHE-ZDM-P
Practice Address - Street 2:PULMONARY/CRITICAL CARE, 3551 ROGER BROOKE DR
Practice Address - City:JBSA-FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234
Practice Address - Country:US
Practice Address - Phone:210-916-2153
Practice Address - Fax:210-916-0709
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.135308207R00000X
NE29759207R00000X, 208D00000X, 207RC0200X
390200000X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0330051Medicaid