Provider Demographics
NPI:1689221129
Name:THOMAS, DEAN ASHLEY JR (DD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ASHLEY
Last Name:THOMAS
Suffix:JR
Gender:M
Credentials:DD
Other - Prefix:DR
Other - First Name:DEAN
Other - Middle Name:ASHLEY
Other - Last Name:THOMAS
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:DJ THOMAS
Mailing Address - Street 1:1218 W QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-2502
Mailing Address - Country:US
Mailing Address - Phone:918-565-9746
Mailing Address - Fax:
Practice Address - Street 1:3427 N BIRMINGHAM AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74110-1512
Practice Address - Country:US
Practice Address - Phone:918-565-9746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty