Individual ProviderBrian K ThomasNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address542 Mockingbird Ln, Shreveport, LA 71105-4322(318) 840-2209PECOS EnrollmentBased on the most recent information from CMS, provider Brian K Thomas does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1104654250Provider TypeIndividualFull NameThomas, Brian KTitleMr.GenderMaleSole ProprietorYesEnumeration Date7/22/2024Last Updated12/30/2025Contact InformationPractice LocationPractice Address542 Mockingbird Ln, Shreveport, LA 71105-4322Phone(318) 840-2209FaxUnlisted FaxMailing LocationMailing Address542 Mockingbird Ln, Shreveport, LA 71105-4322Phone(318) 840-2209FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense201131LouisianaCode163WC0200XDescriptionRegistered NurseNursing Service ProvidersLicense201131Louisiana