Basic Information
Provider Information
NPI: 1326408774
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THOMATIS
FirstName: SARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8906 SPANISH RIDGE AVE STE 202
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891481319
CountryCode: US
TelephoneNumber: 7023303102
FaxNumber: 7029124994
Practice Location
Address1: 1950 PINTO LN
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891064017
CountryCode: US
TelephoneNumber: 7024382229
FaxNumber: 7023850982
Other Information
ProviderEnumerationDate: 02/27/2016
LastUpdateDate: 07/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XDO2737NVY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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