Provider Demographics
NPI:1265847610
Name:DIXON, THOMAS ROSS
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ROSS
Last Name:DIXON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N N ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-6409
Mailing Address - Country:US
Mailing Address - Phone:432-262-2440
Mailing Address - Fax:432-262-2442
Practice Address - Street 1:100 N N ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6409
Practice Address - Country:US
Practice Address - Phone:432-262-2440
Practice Address - Fax:432-262-2442
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX02432111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor