Organization · Type 2 NPI
Thomas Deporter, Md, PA
Medical Specialty Clinic/Center · Benbrook, TX
Practice location
6410 Southwest Blvd Ste 100
Benbrook, TX 76109-3918
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Specialty Clinic/Center Primary | 261QM2500X | None listed |
Medical Specialty Clinic/Center: 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).
About NPI 1407530413
Thomas Deporter, Md, PA's National Provider Identifier is 1407530413, issued on Jun 12, 2023. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Benbrook, TX. The record was last updated on Jun 12, 2023.