Provider Demographics
NPI:1003831934
Name:THOMAS C. BINZER M.D.,P.A.
Entity Type:Organization
Organization Name:THOMAS C. BINZER M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BINZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PA
Authorized Official - Phone:817-598-8200
Mailing Address - Street 1:PO BOX 200
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-0200
Mailing Address - Country:US
Mailing Address - Phone:817-598-8200
Mailing Address - Fax:817-598-8201
Practice Address - Street 1:907 EUREKA
Practice Address - Street 2:SUITE A
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086
Practice Address - Country:US
Practice Address - Phone:817-598-8200
Practice Address - Fax:817-598-8201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1070174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0078PWOtherBCBS
TXDG8376OtherMEDICARE RAILROAD GROUP
TX200032933OtherPALMETTO GBA
TX200032933OtherPALMETTO GBA
TXDG8376OtherMEDICARE RAILROAD GROUP
TX00663ZMedicare PIN