Provider Demographics
NPI:1023014917
Name:BROOKS, THOMAS E III (DPM)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:E
Last Name:BROOKS
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 LUBBOCK ST
Mailing Address - Street 2:STE B
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8235
Mailing Address - Country:US
Mailing Address - Phone:956-428-2442
Mailing Address - Fax:956-428-3132
Practice Address - Street 1:1911 LUBBOCK ST
Practice Address - Street 2:STE B
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8235
Practice Address - Country:US
Practice Address - Phone:956-428-2442
Practice Address - Fax:956-428-3132
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0881213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112214502Medicaid
TX112214501Medicaid
TX112214501Medicaid
TX112214502Medicaid