Provider Demographics
NPI:1164512414
Name:FROEHLICH, THOMAS W (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:FROEHLICH
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:UTSW BILLING
Mailing Address - Street 2:P.O. BOX 845347
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0001
Mailing Address - Country:US
Mailing Address - Phone:214-645-0600
Mailing Address - Fax:214-645-2762
Practice Address - Street 1:UT SOUTHWESTERN
Practice Address - Street 2:5323 HARRY HINES BLVD.
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-8852
Practice Address - Country:US
Practice Address - Phone:214-648-4180
Practice Address - Fax:214-648-1955
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2252207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201190022Medicaid
MO201190030Medicaid
MOA12912Medicare UPIN
MO201190030Medicaid
MO154013230Medicare PIN