Light, Jerry Thomas

Light, Jerry Thomas is an individual health care provider with primary practice located at 1604 Hospital Pkwy Ste 501 , Bedford TX 76022-6932. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Light, Jerry Thomas can be contacted via phone (817) 684-2700.

Contact Information

Primary practice address
1604 Hospital Pkwy Ste 501 Bedford TX 76022-6932
Phone: (817) 684-2700
Fax: (817) 684-2709
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X K3785 Texas

Profile Details

NPI number 1831198720
LBN Legal business name Light, Jerry Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Jan 30th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831198720 NPPES
Texas MEDICAID 046401803

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