Provider Demographics
NPI:1417656158
Name:THOMAS, LIJI (FNP-C)
Entity type:Individual
Prefix:
First Name:LIJI
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14334 N ROOTH RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-4343
Mailing Address - Country:US
Mailing Address - Phone:956-270-1650
Mailing Address - Fax:
Practice Address - Street 1:5600 S VETERANS BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542
Practice Address - Country:US
Practice Address - Phone:956-450-2625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-02
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1111712363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1111712OtherTEXAS BOARD OF NURSING