Provider Demographics
NPI:1326029497
Name:THOMAS, DARRYL BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:BRIAN
Last Name:THOMAS
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 1:5408 N SCOUT ISLAND CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6533
Mailing Address - Country:US
Mailing Address - Phone:512-964-9746
Mailing Address - Fax:512-215-9652
Practice Address - Street 1:3110 GUADALUPE ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2858
Practice Address - Country:US
Practice Address - Phone:512-599-9510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0590207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine