Provider Demographics
NPI:1154467660
Name:NABORS, THOMAS DAMIAN (DDS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:DAMIAN
Last Name:NABORS
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 1:3000 N MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-4449
Mailing Address - Country:US
Mailing Address - Phone:972-252-8551
Mailing Address - Fax:972-594-2306
Practice Address - Street 1:3000 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4449
Practice Address - Country:US
Practice Address - Phone:972-252-8551
Practice Address - Fax:972-594-2306
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12606122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD12606OtherBLUE CROSS BLUE SHIELD
TX451811OtherUNITED CONCORDIA