Provider Demographics
NPI:1154306561
Name:GREER, THOMAS DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DAVID
Last Name:GREER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:102 SOUTH ARCHER
Mailing Address - City:HENRIETTA
Mailing Address - State:TX
Mailing Address - Zip Code:76365
Mailing Address - Country:US
Mailing Address - Phone:940-538-4336
Mailing Address - Fax:940-538-6271
Practice Address - Street 1:102 SOUTH ARCHER
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:TX
Practice Address - Zip Code:76365
Practice Address - Country:US
Practice Address - Phone:940-538-4336
Practice Address - Fax:940-538-6271
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD1654207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081434501Medicaid
TX121133602Medicaid
TXD1654OtherSTATE LIC
TX0095BMMedicare ID - Type UnspecifiedGROUP
TX121133602Medicaid
TX081434501Medicaid