Provider Demographics
NPI:1083097273
Name:SAMMONS, THOMAS WALKER (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WALKER
Last Name:SAMMONS
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 1:116 E TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:RAYNE
Mailing Address - State:LA
Mailing Address - Zip Code:70578-5822
Mailing Address - Country:US
Mailing Address - Phone:337-334-3581
Mailing Address - Fax:337-334-2812
Practice Address - Street 1:116 E TEXAS AVE
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-5822
Practice Address - Country:US
Practice Address - Phone:337-334-3581
Practice Address - Fax:337-334-2812
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6889122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist