Provider Demographics
NPI:1366950743
Name:THOMAS, BUCY ANNIE RAJAN (NP)
Entity type:Individual
Prefix:
First Name:BUCY
Middle Name:ANNIE RAJAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:BUCY
Other - Middle Name:ANNIE
Other - Last Name:RAJAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6800 NW 39TH EXPY
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-2513
Mailing Address - Country:US
Mailing Address - Phone:405-789-6711
Mailing Address - Fax:405-349-5145
Practice Address - Street 1:6800 NW 39TH EXPY
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-2513
Practice Address - Country:US
Practice Address - Phone:405-789-6711
Practice Address - Fax:405-349-5145
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK93257207Q00000X, 2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine