Provider Demographics
NPI:1043656820
Name:TCBMD, LLC
Entity Type:Organization
Organization Name:TCBMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD SOLE MB
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-384-3433
Mailing Address - Street 1:1302 LAKEWOOD DR
Mailing Address - Street 2:STE 102
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-1889
Mailing Address - Country:US
Mailing Address - Phone:985-384-3433
Mailing Address - Fax:985-384-3453
Practice Address - Street 1:1302 LAKEWOOD DR
Practice Address - Street 2:STE 102
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1889
Practice Address - Country:US
Practice Address - Phone:985-384-3433
Practice Address - Fax:985-384-3453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD2020161208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty