Provider Demographics
NPI:1174130256
Name:THOMAS, DANIEL WORU
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:WORU
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 1:380 VISTA COURT DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-8388
Mailing Address - Country:US
Mailing Address - Phone:347-576-4732
Mailing Address - Fax:
Practice Address - Street 1:380 VISTA COURT DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-8388
Practice Address - Country:US
Practice Address - Phone:347-576-4732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9532226163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse