Provider Demographics
NPI:1033267794
Name:KNIGHT, THOMAS W (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:W
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6565 FANNIN
Mailing Address - Street 2:M1-072
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2707
Mailing Address - Country:US
Mailing Address - Phone:713-441-3488
Mailing Address - Fax:713-790-3781
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SMITH 1101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-0006
Practice Address - Fax:713-790-2727
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC52449207R00000X
TXN4526207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210045502Medicaid
TX210045501Medicaid
TX1033267794OtherBLUE CROSS BLUE SHIELD
TXP01055780OtherRR MEDICARE
TX1033267794OtherBLUE CROSS BLUE SHIELD
TXTXB135678Medicare PIN