Provider Demographics
NPI:1275693533
Name:THOMAS J BYRNE MD PLLC
Entity Type:Organization
Organization Name:THOMAS J BYRNE MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-397-5500
Mailing Address - Street 1:4761 BROADWAY
Mailing Address - Street 2:APT 3 Z
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-4935
Mailing Address - Country:US
Mailing Address - Phone:405-397-5500
Mailing Address - Fax:
Practice Address - Street 1:122 S GOLD AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-3755
Practice Address - Country:US
Practice Address - Phone:505-546-3340
Practice Address - Fax:505-546-3958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-09
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1620641207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty