Sheela Thomas

Individual provider Active NPI General Practice Dentistry · Quinlan, TX

NPI 1356409452 · NPPES record last updated Jun 4, 2021

Key facts

NPI
1356409452
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
21088 (TX)
Practice address
711 E Quinlan Pkwy
Quinlan, TX 75474-8641
Phone
(903) 356-5319
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160321001441 TX Order and Referring Only - Dentist
Practitioner - Dentist
5890009435

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
21088TXMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21088 TX Yes

Addresses

Primary practice location

711 E Quinlan Pkwy
Quinlan, TX 75474-8641

Mailing address

PO Box 940
Quinlan, TX 75474-0016
Phone (903) 356-5319

Other providers in Quinlan, TX

All providers in Quinlan, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.