Provider Demographics
NPI:1336119270
Name:EWING, THOMAS NAGEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:NAGEL
Last Name:EWING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 TOWN AND COUNTRY BLVD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-3925
Mailing Address - Country:US
Mailing Address - Phone:713-467-3458
Mailing Address - Fax:713-467-7902
Practice Address - Street 1:791 TOWN AND COUNTRY BLVD
Practice Address - Street 2:SUITE 222
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3925
Practice Address - Country:US
Practice Address - Phone:713-467-3458
Practice Address - Fax:713-467-7902
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11260122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist