Provider Demographics
NPI:1366818288
Name:JOHN THURMOND, M.D. AND ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:JOHN THURMOND, M.D. AND ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:IRA
Authorized Official - Last Name:THURMOND
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:817-368-7239
Mailing Address - Street 1:4621 S COOPER ST STE 131
Mailing Address - Street 2:#810
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5815
Mailing Address - Country:US
Mailing Address - Phone:817-368-7239
Mailing Address - Fax:830-632-6568
Practice Address - Street 1:2809 KATHERINE CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4039
Practice Address - Country:US
Practice Address - Phone:817-368-7239
Practice Address - Fax:830-632-6568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1218207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty