Provider Demographics
NPI:1851266829
Name:THOMAS, JORGE
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 HACKBERRY CT
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8319
Mailing Address - Country:US
Mailing Address - Phone:956-455-2731
Mailing Address - Fax:
Practice Address - Street 1:7075 N EXPRESSWAY 77 SUITE. 2
Practice Address - Street 2:
Practice Address - City:OLMITO
Practice Address - State:TX
Practice Address - Zip Code:78575
Practice Address - Country:US
Practice Address - Phone:956-280-5690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-08
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician