Provider Demographics
NPI:1275890634
Name:FOGARTY, THOMAS PATRICK III (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PATRICK
Last Name:FOGARTY
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:ONE BAYLOR PLAZA
Mailing Address - Street 2:BCM 320, DEPARTMENT OF PEDIATRIC CRITICAL CARE MEDICINE
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3411
Mailing Address - Country:US
Mailing Address - Phone:832-826-6230
Mailing Address - Fax:
Practice Address - Street 1:1 BAYLOR PLZ
Practice Address - Street 2:BCM 320, DEPARTMENT OF PEDIATRICS
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3411
Practice Address - Country:US
Practice Address - Phone:832-824-1170
Practice Address - Fax:832-825-9302
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2018-04-23
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Provider Licenses
StateLicense IDTaxonomies
TXQ54042080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care MedicineGroup - Multi-Specialty