Provider Demographics
NPI:1346435732
Name:W DENNIS TOBIN MD PA
Entity Type:Organization
Organization Name:W DENNIS TOBIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:W
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:361-579-1361
Mailing Address - Street 1:PO BOX 3441
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77903
Mailing Address - Country:US
Mailing Address - Phone:361-579-1361
Mailing Address - Fax:361-579-1365
Practice Address - Street 1:2700 CITIZEN PLAZA
Practice Address - Street 2:SUITE 303
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901
Practice Address - Country:US
Practice Address - Phone:361-579-1361
Practice Address - Fax:361-579-1365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1278174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195176601Medicaid
TX195176601Medicaid
TXC43491Medicare UPIN