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Thomas Deporter, Md, Pa
Medical Specialty Clinic/Center in Benbrook, Texas
NPI 1407530413

Thomas Deporter, Md, Pa is a Medical Specialty Clinic/Center based in Benbrook, TX and is specialized in Medical Specialty. Thomas Deporter, Md, Pa practices in Benbrook, TX. The NPI Number for Thomas Deporter, Md, Pa is 1407530413 and holds a License No. (Texas).

The current practice location address for Thomas Deporter, Md, Pa is 6410 Southwest Blvd Ste 100, Benbrook, TX and can be reached out via phone at 682-224-1703.

Location: 6410 Southwest Blvd Ste 100, Benbrook, TX, 76109-3918
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1407530413
Provider Name
Thomas Deporter, Md, Pa
Credential
Provider Entity Type
Organization
Address
6410 Southwest Blvd Ste 100, Benbrook, TX, 76109-3918
Phone Number
682-224-1703
Fax Number
Provider Enumeration Date
06/12/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
6410 Southwest Blvd Ste 100
City
Benbrook
State
Texas
Zip
76109-3918
Phone Number
682-224-1703
Fax Number
person
Provider Business Mailing Address Details
Address
6410 Southwest Blvd Ste 100
City
Benbrook
State
Texas
Zip
76109-3918
Phone Number
682-224-1703
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
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Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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