Provider Demographics
NPI:1043296312
Name:BARTON, THOMAS SCOTT (DDS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:SCOTT
Last Name:BARTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5983 BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1822
Mailing Address - Country:US
Mailing Address - Phone:210-681-4867
Mailing Address - Fax:210-681-3831
Practice Address - Street 1:5983 BANDERA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1822
Practice Address - Country:US
Practice Address - Phone:210-681-4867
Practice Address - Fax:210-681-3831
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD2225122300000X
TX158891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX15889OtherDENTAL LICENSE
TX133327014Medicaid