Provider Demographics
NPI:1730532094
Name:THOMAS, CARLA FRANCES HUGUS (DDS)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:FRANCES HUGUS
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8008 BRONCO LN STE B
Mailing Address - Street 2:
Mailing Address - City:LAGO VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78645-4150
Mailing Address - Country:US
Mailing Address - Phone:512-277-3311
Mailing Address - Fax:
Practice Address - Street 1:8008 BRONCO LN
Practice Address - Street 2:
Practice Address - City:LAGO VISTA
Practice Address - State:TX
Practice Address - Zip Code:78645
Practice Address - Country:US
Practice Address - Phone:512-277-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-21
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32029122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist